CtDNA-guided de-escalation of adjuvant chemotherapy in stage III colon cancer: early model-based evaluation of cost-effectiveness.

ABSTRACT:

Background

All stage III colon cancer (CC) patients are recommended adjuvant chemotherapy (ACT) after surgery, while over half are already cured by surgery alone. The prognostic biomarker circulating tumor DNA (ctDNA) could potentially guide the decision on whom to withhold ACT.

Objective

We assessed the cost-effectiveness of ctDNA-guided ACT de-escalation in stage III CC.

Design

A decision model "PATTERN-stageIII" simulates CC from diagnosis till death in surgically treated stage III patients.

Methods

We evaluated administering ACT in all patients (i.e., All ACT strategy), and three ACT de-escalation strategies by omitting ACT in patients who are (Strategy 1) both pT1-3N1 and ctDNA-negative, (Strategy 2) pT1-3N1, have no vascular invasion, and are ctDNA-negati

SUBMITTER: Wang H 

PROVIDER: S-EPMC12592672 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature