The Role of Circulating Tumor DNA (ctDNA) in Colorectal Cancer Management - Pashtoon Kasi MD, MS

In this video, we explore the critical role of circulating tumor DNA (ctDNA), or liquid biopsies, in managing colorectal cancer across different stages. Our expert guest discusses how ctDNA testing is revolutionizing patient care, especially for those with stage II and III colorectal cancer, by providing nuanced insights into treatment decisions.

Key topics covered in this video include:
The complexity of deciding on adjuvant chemotherapy for stage II patients.
The significance of the dynamic study from Rasco, which showed that a ctDNA-directed approach could reduce unnecessary chemotherapy while maintaining efficacy.
The difference between pathologic risk factors and ctDNA positivity in predicting cancer recurrence.
How ctDNA can influence treatment choices, particularly when positive results indicate the presence of residual disease.
The implications of ctDNA in surveillance post-chemotherapy, including when and how to escalate imaging based on positive results.
Ongoing clinical trials focusing on patients with positive ctDNA who have not yet shown radiographic recurrence, exploring innovative treatments like vaccine-based therapies.
The prognostic value of ctDNA, with insights into what patients can expect from their test results.

This discussion is based on a recent presentation and publication from ASCO GI 2025, offering a forward-looking perspective on how this biomarker is shaping the future of colorectal cancer treatment. Whether you're a patient, a caregiver, or a healthcare professional, this video provides valuable information on how ctDNA testing could impact colorectal cancer management strategies.

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Timestamps:
0:00 - Introduction to ctDNA in Colorectal Cancer
1:00 - The Decision-Making Process for Stage II Patients
2:30 - Insights from the Dynamic Study
4:00 - Pathologic Risk vs. ctDNA Positivity
5:30 - Influence on Treatment Decisions
7:00 - ctDNA in Post-Chemotherapy Surveillance
8:30 - Current Clinical Trials and Future Directions
10:00 - Prognostic Implications of ctDNA Testing
11:30 - Conclusion and Future Expectations

Join us in this insightful journey into the world of precision oncology. Remember, knowledge is power in the fight against cancer.