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).
Quick facts
| Phase | Phase 2 |
|---|---|
| Study type | Interventional |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Enrollment | 100 (estimated) |
| Sponsor | Fudan University Academic / other |
| Drugs / interventions | bevacizumab |
| Locations | 1 site (Shanghai) |
| Status | Recruiting |
| Started | April 1, 2025 |
| Main results expected | December 31, 2027 |
| Study ends | December 31, 2027 |
| Registry record updated | May 1, 2026 |
| Trial ID | NCT07562490 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
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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.
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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 people with T4N0 and low‑risk stage III colorectal cancer.
This trial will test whether using a blood test (plasma ctDNA methylation) to guide 3 vs 6 months of adjuvant chemotherapy or to switch regimens helps people with T4N0 or low‑risk stage III colorectal cancer after surgery.
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Chemo Brain Prehab for older adults with colorectal cancer
This program tests whether an exercise-based prehabilitation plan, with or without vitamins, can reduce chemo brain and improve quality of life for adults aged 60–85 undergoing chemotherapy for colorectal cancer.
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Combining targeted therapies for solid tumors using CDK4/6 inhibitors and anti-VEGF agents
This study is testing if combining two cancer treatments, Palbociclib and Bevacizumab, can help people with solid tumors like colorectal, breast, and ovarian cancers feel better and respond better to treatment.
-
ctDNA blood tests to guide treatment in colorectal cancer with liver metastases
A study using blood tests that look for tumor DNA to help decide which patients with colorectal cancer that has spread to the liver need more treatment after surgery.
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Investigating dizziness and muscle weakness in older colorectal cancer patients during chemotherapy
This study is testing whether a special exercise program and health check-ups can help older colorectal cancer patients feel less dizzy and improve their balance during chemotherapy.
How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.