Clinical trial Recruiting at 1 site Phase 2 Interventional Ages 18 to 80

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

Official title: A Randomized Controlled Trial of Plasma ctDNA Methylation-Guided Adjuvant Chemotherapy Decision-Making in High-Risk Stage III (T4N+ or T1-3N2) Colorectal Cancer

Run by Fudan University · NCT07562490 · Data updated 2026-11-12

This trial will test whether adding bevacizumab to standard FOLFOX or CAPOX chemotherapy based on plasma ctDNA results helps adults with high-risk stage III colorectal cancer (T4N+ or T1-3N2).

More Colorectal Cancer trials

Quick facts

PhasePhase 2
Study typeInterventional
Ages18 Years to 80 Years
SexAll
Enrollment100 (estimated)
SponsorFudan University
Academic / other
Drugs / interventionsbevacizumab
Locations1 site (Shanghai)
StatusRecruiting
StartedApril 1, 2025
Main results expectedDecember 31, 2027
Study endsDecember 31, 2027
Registry record updatedMay 1, 2026
Trial IDNCT07562490 on ClinicalTrials.gov

Is this trial a fit for you?

Likely a good fit

Adults (≥18 years) with histologically confirmed high-risk stage III colorectal cancer (T4N+ or T1-3N2) who are ctDNA-positive one month after surgery and can receive FOLFOX/CAPOX are ideal candidates.

Probably not a fit

Patients who are ctDNA-negative after surgery, cannot tolerate bevacizumab or standard chemotherapy, or who received neoadjuvant therapy are unlikely to benefit from this protocol.

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 adults with high-risk stage III colorectal cancer who are ctDNA-positive one month after surgery and assigns them to standard adjuvant chemotherapy (FOLFOX/CAPOX for 6 months) or the same chemotherapy plus bevacizumab for 6 months. Venous blood samples are collected at 1, 3, and 6 months postoperatively to monitor dynamic changes in plasma ctDNA methylation. Treatment decisions are guided by postoperative ctDNA status and patients are followed for treatment response and clinical outcomes. The trial is conducted at Fudan University Shanghai Cancer Center.

Why it matters

Potential benefit: If successful, this approach could reduce cancer recurrence by identifying patients with molecular residual disease who may benefit from adding bevacizumab to standard adjuvant chemotherapy.

How similar studies have gone: Using postoperative ctDNA to guide adjuvant therapy is an emerging approach with several trials showing ctDNA predicts recurrence, but the benefit of adding bevacizumab in this specific adjuvant, ctDNA-guided setting is not well established.

Who can join: the full rules

Show full inclusion / exclusion criteria
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

Similar studies

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

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.
Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.