Oncology Today with Dr Neil Love Colorectal Cancer — A Roundtable Discussion on the Use of Molecular Residual Disease Analysis
Feb 26, 2026
Dr Christopher Lieu, medical oncologist at the University of Colorado studying ctDNA in colorectal cancer. Dr Arvind Dasari, MD Anderson oncologist focused on MRD trials and translational research. Dr Stacey A Cohen, University of Washington oncologist expert in ctDNA biology. They discuss ctDNA/MRD biology, tumor‑informed vs tumor‑agnostic assays, surveillance strategies, trial landscapes, and practical uses for guiding imaging, surgery, and adjuvant decisions.
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Fix Tissue Logistics To Speed TumorInformed Tests
- Push labs and pathology logistics to shorten tumor‑informed ctDNA turnaround because tissue retrieval, not sequencing, is often the bottleneck.
- Stacey A Cohen noted companies can speed assays but cannot force pathology departments to expedite sample transfer.
Enroll MRD Positive Patients In Efficient Trials
- Prioritize clinical trials for MRD‑positive patients because event rates are high and timelines short, enabling efficient drug evaluation.
- Arvind Dasari explained MRD+ patient trials can complete with ~200–250 patients over months given recurrence timing of ~6–9 months.
ctDNA Beats CEA For Detecting Oligometastatic Recurrence
- ctDNA outperforms CEA for identifying patients who undergo metastasis‑directed therapy, and consecutive ctDNA negatives beyond ~18 months predict <2% recurrence risk.
- Dasari reported pooled Galaxy/Bespoke data: MDT rate 32% for ctDNA+ vs 2% for ctDNA− and low recurrence after sustained ctDNA negativity.