Plasma ctDNA methylation-guided adjuvant chemotherapy for people with T4N0 and low‑risk stage III colorectal cancer.

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This randomized phase 2 trial enrolls patients with T4N0 or low‑risk stage III colorectal cancer who are ctDNA‑positive one month after surgery and randomizes them to a control or intervention arm. The control arm receives standard adjuvant chemotherapy (FOLFOX or CAPOX) for 3 months, while the intervention arm receives either 6 months of FOLFOX/CAPOX or 3 months of FOLFOX/CAPOX followed by 3 months of FOLFIRI/CAPIRI guided by plasma ctDNA methylation results. Venous blood samples (8–16 mL) are collected at 1, 3, and 6 months postoperatively for dynamic ctDNA methylation monitoring to inform treatment decisions. The trial is conducted at Fudan University Shanghai Cancer Center and is designed to test whether methylation‑guided therapy can refine adjuvant treatment duration or regimen choice.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Age ≥18 years, regardless of sex;
2. Eastern Cooperative Oncology Group (ECOG) performance status of 0-2, with an expected survival of \>3 months;
3. Histologically confirmed postoperative pTNM stage high-risk stage II colorectal cancer;
4. Positive ctDNA status at 1 month after surgery;
5. Expected survival of \>12 months;
6. Ability to understand and willingness to sign a written informed consent form (personally or via a legally authorized representative/guardian), indicating that the subject understands the study objectives and required procedures and agrees to participate.

Exclusion Criteria:

1. Receipt of neoadjuvant therapy prior to surgery;
2. Blood transfusion during surgery or within 2 weeks prior to surgery;
3. Pregnant or breastfeeding women, or individuals of reproductive potential who are not using adequate contraception;
4. History of other malignancies within the past 5 years, except for adequately treated carcinoma in situ of the cervix or non-melanoma skin cancer;
5. Uncontrolled primary brain tumors or central nervous system metastases, or presence of significant intracranial hypertension or neuropsychiatric symptoms;
6. Presence of severe or uncontrolled comorbidities, including but not limited to:Severe cardiac disease that remains unstable despite treatment, including myocardial infarction, congestive heart failure, unstable angina, symptomatic pericardial effusion, or unstable arrhythmia within 6 months prior to enrollment; Clearly diagnosed neurological or psychiatric disorders, including dementia or seizure disorders;Severe or uncontrolled infections;Active disseminated intravascular coagulation (DIC) or significant bleeding tendency;Significant impairment of major organ function;
7. Any other condition that, in the opinion of the investigator, would make the patient unsuitable for participation in this study.

Where it's running

• Fudan University Shanghai Cancer Center
  Shanghai, China Recruiting

Study contacts

• Study coordinator: Guoxiang Cai
• Email: gxcaifuscc@163.com
• Phone: 86-18017312703

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Using plasma ctDNA methylation to guide adjuvant chemotherapy for high-risk T3N0 colorectal cancer

  This will test whether a blood ctDNA methylation test can help choose stronger chemotherapy after surgery for people with high-risk T3N0 (stage II) colorectal cancer who are ctDNA-positive one month after surgery.

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• Plasma ctDNA methylation–guided adjuvant chemotherapy for high-risk stage III colorectal cancer

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• Chemo Brain Prehab for older adults with colorectal cancer

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• ctDNA blood tests to guide treatment in colorectal cancer with liver metastases

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• Investigating dizziness and muscle weakness in older colorectal cancer patients during chemotherapy

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.