DYNAMIC
Showed that a blood test can safely halve the number of colon cancer patients given chemotherapy after surgery.
ctDNA-guided arm: 15% received chemotherapy vs 28%; 2-year RFS non-inferior (93.5% vs 92.4%). NEJM 2022. DYNAMIC-III (stage III) followed with more nuanced results.
- 93.5 vs 92.4 out of 100 alive without the cancer coming back at 2 years with ctDNA-guided management compared with Standard management; 1.1 more per 100.
- Roughly one extra person helped for every 91 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- 15 vs 28 out of 100 reached this endpoint with ctDNA-guided management compared with Standard management; 13 fewer per 100.
- On this measure the first group did worse, not better.
- The p-value (<0.001) says a difference this large would rarely happen by chance; it does not say how large or how useful the difference is.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- These results apply to the people the trial enrolled: Stage II colon cancer: ctDNA-guided adjuvant chemotherapy vs standard management. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
455 participants enrolled.
Non-inferiority met (margin −8.5 points)
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Recurrence-free survival at 2 years (non-inferiority)primary | ctDNA-guided management | 302 | 93.5% | — | — | link |
| Standard management | 153 | 92.4% | ||||
| Patients receiving adjuvant chemotherapy | ctDNA-guided management | — | 15% | — | <0.001 | link |
| Standard management | — | 28% |
Pages like this
not linked directly; found by shared links- TrialIMvigor011
Shares Use tumour DNA in blood to decide when to pause treatment in metastatic cancer, A national platform trial that every ctDNA-positive patient can join, A national residual-disease weather service: serial blood tests for every curatively treated patient, pooled, Formally qualify tumour-DNA blood tests as a surrogate endpoint for adjuvant trials.
- Key paperGALAXY: tumour DNA in blood four weeks after bowel cancer surgery predicts relapse tenfold
Shares ctDNA-guided adjuvant therapy as the default in stage II-III colon cancer, Formally qualify tumour-DNA blood tests as a surrogate endpoint for adjuvant trials, DYNAMIC: a blood test safely halved chemotherapy use after surgery for stage II colon cancer, Dormant cells and minimal residual disease.
- ProductSignatera
Shares ctDNA-guided adjuvant therapy as the default in stage II-III colon cancer, A national residual-disease weather service: serial blood tests for every curatively treated patient, pooled, Formally qualify tumour-DNA blood tests as a surrogate endpoint for adjuvant trials, ctDNA MRD → adjuvant therapy decision.
- IdeactDNA-triggered escalation in early TNBC
Shares A national residual-disease weather service: serial blood tests for every curatively treated patient, pooled, ctDNA MRD → adjuvant therapy decision, Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD).
- IdeaBlunt the inflammation that wakes sleeping cancer cells
Shares Metastasis is understood least and studied last, Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), MRD / molecular residual disease testing.
- IdeaFlush dormant cells out of bone marrow, then kill them
Shares Metastasis is understood least and studied last, Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), MRD / molecular residual disease testing.
- IdeaMetastasis prevention as a formal indication with its own trials and regulatory pathway
Shares Metastasis is understood least and studied last, Minimal / molecular residual disease (MRD), MRD / molecular residual disease testing, Colorectal cancer.
- IdeaKeep dormant cells asleep instead of trying to kill them
Shares Metastasis is understood least and studied last, Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), MRD / molecular residual disease testing.