The CIRCULATE Trial: Circulating Tumor DNA Based Decision for Adjuvant Treatment in Colon Cancer Stage II Evaluation (AIO-KRK-0217)

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Gunnar Folprecht - , Department of Internal Medicine I, German Cancer Consortium (DKTK) Partner Site Dresden (Author)
  • Anke Reinacher-Schick - , Ruhr University Bochum, Catholic Hospital Bochum gGmbH (Author)
  • Jürgen Weitz - , Department of Visceral, Thoracic and Vascular Surgery, German Cancer Consortium (DKTK) Partner Site Dresden (Author)
  • Celine Lugnier - , Ruhr University Bochum, Catholic Hospital Bochum gGmbH (Author)
  • Anna-Lena Kraeft - , Ruhr University Bochum, Catholic Hospital Bochum gGmbH (Author)
  • Sarah Wisser - , Ruhr University Bochum (Author)
  • Daniela E Aust - , Institute of Pathology, German Cancer Consortium (DKTK) Partner Site Dresden (Author)
  • Lukas Weiss - , Paracelsus Private Medical University (Author)
  • Nikolas von Bubnoff - , University Hospital Schleswig-Holstein - Campus Lübeck (Author)
  • Michael Kramer - , Department of internal Medicine I (Author)
  • Christian Thiede - , Department of Internal Medicine I, German Cancer Consortium (DKTK) Partner Site Dresden (Author)
  • Andrea Tannapfel - , Ruhr University Bochum (Author)

Abstract

Background: Guidance regarding adjuvant treatment decisions in stage II colorectal cancer (CRC) remains uncertain due to lack of predictive clinical or molecular markers. Recently, postoperative circulating tumour (ct)DNA has been demonstrated to be a strong prognostic marker in early colon cancer. Patients and Methods: CIRCULATE enrols patients with stage II microsatellite stable CRC in Germany (AIO) and Austria (ABCSG). Within the AIO, screening is supported by ColoPredict Plus 2.0, a molecular registry, and screening platform for interventional trials. Patient-specific mutations are centrally analysed by next generation sequencing in the resected primary tumour. A postoperative plasma sample is subsequently screened for the specific mutation(s). ctDNA positive (ctDNApos) patients are randomised (2:1) chemotherapy (capecitabine, oxaliplatin added an investigator's choice) or to follow-up (control group). ctDNA negative (ctDNAneg) patients are randomised (1:4) to be followed-up within CIRCULATE (control group) or outside the trial. Patients in the control group remain blinded to the ctDNA results. The primary objective is to compare disease free survival (DFS) of ctDNApos patients with chemotherapy or control. To demonstrate a treatment effect with a hazard ratio of 0.617 (3-year DFS rates 42.5% vs. 25%), 231 ctDNApos and estimated 2079 ctDNAneg patients are randomised. Secondary aims include to compare overall survival and DFS in the ctDNApos and ctDNAneg patient cohorts and ctDNA kinetics. Conclusion: The CIRCULATE trial may establish ctDNA for adjuvant treatment decision in stage II colon cancer – and with the secondary objectives – support a ctDNA guided follow up in colon cancer stage II and beyond.

Details

Original languageEnglish
Pages (from-to)170-174
Number of pages5
JournalClinical colorectal cancer
Volume21
Issue number2
Publication statusPublished - Jun 2022
Peer-reviewedYes

External IDs

Scopus 85118871941
Mendeley 4ddeb9c5-d8c5-3931-b8fa-a141370acfb6

Keywords

Sustainable Development Goals