The CIRCULATE study, comprised of investigators from Arbeitsgemeinschaft Internistische Onkologie (AIO) and the Austrian Breast and Colorectal Cancer Study Group (ABCSG) "evaluated a treatment escalation strategy [to determine] whether patients with circulating tumour DNA (ctDNA)-positive status would benefit from capecitabine-based adjuvant chemotherapy after resection for stage II colon cancer". While the study could not be fully completed due to lapse of funding, preliminary results indicated that time to recurrence and disease-free survival were improved with chemotherapy vs. observation: 3-year recurrence was 19% vs. 62%, while 3-year disease-free survival was 77% compared to 38%.
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Sources mentioned:
- Folprecht G, Stasik S, Reinacher-Schick, et al. Chemotherapy for patients with circulating tumour DNA-positive, stage II colon cancer (CIRCULATE)—an AIO/ABCSG trial . Annals of Oncology; Published online 31 May 2026. DOI: 10.1016/j.annonc.2026.05.001
- Folprecht G, Stasik S, Christmann J, et al. Disease-free survival (DFS) and time to recurrence (TTR) with circulating tumor (ct) DNA–based decision for adjuvant treatment in colon cancer stage II (CIRCULATE): An AIO (KRK-0217)/ABCSG trial . J Clin Oncol 2026;44:(suppl 17; abstr LBA3500).
- Tarazona N, Parikh A. ctDNA-guided adjuvant therapy in stage II colon cancer: a step forward, but not the final word . Annals of Oncology; Published online 11 June 2026. DOI: 10.1016/j.annonc.2026.06.002
ctDNA-guided decisions in stage II colon cancer are one of the clearest examples of the field moving away from blanket adjuvant treatment toward treating only the patients most likely to benefit. Sparing ctDNA-negative patients chemotherapy they may not need, while acting early for those who test positive, is a genuine step toward personalised follow-up. This is the kind of evidence the oncology brothers discussions keep returning to — a biomarker actually changing a treatment decision rather than just describing risk.
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