excerpt From GALAXY (Nakamura et al., Nat Med 2024;30:3272-3283; PMID 39284954), the updated 23-month-follow-up analysis (n=2,240; stage II-III colon and stage IV CRC) reports that sustained ctDNA clearance under adjuvant chemotherapy (ACT), versus transient clearance, is associated with a dramatic separation in 24-month outcomes: 24-month DFS 89.0% vs 3.3% and 24-month OS 100.0% vs 82.3%. This is the central empirical observation in GALAXY that bears on the sub-topic's question: clearance dynamics under ACT — not just baseline MRD status — stratify outcomes, supplying the observational rationale for ctDNA-guided escalation (when clearance fails to sustain) and de-escalation (when sustained negativity is achieved/maintained) of adjuvant therapy. Caveat for the stage II colon focus: this clearance contrast is reported pooled across the GALAXY cohort (stage II-III colon + stage IV CRC), so its applicability to the sub-topic's specific population is via MRD biology rather than a stage-II-restricted estimate.
nod_3eff4ffc-dcba-437b-aaa0-0bb7d999e2f8
Quoted span
Sustained ctDNA clearance in response to ACT was an indicator of favorable DFS and OS compared to transient clearance (24-month DFS: 89.0% versus 3.3%; 24-month OS: 100.0% versus 82.3%).
Provenance
- Proposed by idn_fc20fc7c-7b35-4993-8d7f-3e1d87a1eba2
- Created 2026-06-01T17:53:25.222Z
- Status: active