Dr. Azzi on the Rationale for the CIRCULATE Study in CRC

Georges Azzi, MD, co-director, Department of Hematology/Oncology, Prostate Cancer, Holy Cross Health, discusses the rationale for the phase 3 CIRCULATE study (NCT04089631) in colorectal cancer (CRC).

Adjuvant chemotherapy has not been shown to have curative potential for all patients with CRC, Azzi says. As such, the goal of the CIRCULATE trial is to attempt to improve upon the current adjuvant chemotherapy regimens that are given to patients after surgery, Azzi explains. The best way to do this is to be able to escalate adjuvant therapy in high-risk patients, Azzi adds.

Moreover, tumor-informed circulating DNA is a valuable tool used to evaluate risk based on minimal residual disease (MRD) status, Azzi continues. If a patient tests positively for MRD 4 weeks after their surgery, they have are at a much higher risk of recurrence, Azzi adds.

In CIRCULATE, ctDNA will be the guiding factor for randomization, wherein patients with MRD-negative disease will de-escalate adjuvant chemotherapy and patients with MRD-positive disease will escalate therapy, Azzi concludes.