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ASCO GI 2025 | ctDNA-guided immunotherapy in MSI-H stage III colon cancer
Jun Gong, MD, Cedars-Sinai Medical Center, Los Angeles, CA, describes a case series which highlights the use of circulating tumor DNA (ctDNA) to guide treatment decisions for patients with microsatellite instability biomarker (MSI-H) stage III colon cancer following curative-intent surgery. While current guidelines recommend oxaliplatin-based chemotherapy in such settings, ctDNA monitoring revealed persistent minimal residual disease (MRD) despite standard treatment, indicating a high likelihood of reoccurrence. Given the strong response of metastatic MSI-H tumors to immunotherapy, a shift to checkpoint inhibitors resulted in ctDNA clearance and sustained remission in both cases. This interview took place at the ASCO GI Cancers Symposium 2025 in San Francisco, CA.
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