ctDNA Monitoring as SOC Surveillance Following CRC Resection: Real-World Applicability

This portion of the discussion centers on the real-world value of circulating tumor DNA (ctDNA) testing, particularly for patients who remain ctDNA-negative beyond 18 to 24 months after treatment. The data provide a stronger foundation for offering reassurance to these patients and support the possibility of reducing the frequency of surveillance imaging. Less frequent scans can ease the emotional and logistical burdens on patients, many of whom face significant disruption in their daily lives when traveling to cancer centers. This evidence-backed approach allows clinicians to responsibly extend surveillance intervals while maintaining confidence in ongoing disease monitoring.

One expert describes their ctDNA surveillance protocol for stage 2 and 3 colorectal cancer: baseline Baseline testing is done at 4– to 6 weeks post-surgery, followed by assessments at 3 and 6 months. If the patient remains ctDNA-negative at all three 3 points, surveillance can shift to every 6 months. For those who remain ctDNA-positive or could notwere unable to complete adjuvant therapy due to side adverse effects, continued 3-month intervals are used to allow for timely detection of recurrence and potential eligibility for localized interventions. While Although ctDNA testing is not yet a formal part of standard guidelines, emerging evidence suggests its growing utility in clinical practice.

Skepticism about ctDNA testing still exists, primarily due to two 2 factors: the lack of consensus on interpreting ctDNA values and the confusion or anxiety caused by insurance denials. Addressing these barriers requires improved patient education about coverage and financial support, as well as continued efforts to demonstrate the test’s clinical validity. Sharing localized data and real-world outcomes has proven useful in increasing acceptance among hesitant providers. Overall, the incorporation of ctDNA testing is seen as beneficial—enhancing surveillance accuracy, supporting earlier interventions, and improving patient quality of life through more personalized care strategies.