Dr. Hubbard on the Utility of MRD Assessment for Stage II CRC

Joleen M. Hubbard, MD, associate professor of oncology, consultant, practice chair, and vice chair, Division of Medical Oncology, Department of Oncology, Mayo Clinic, discusses the utility of minimal residual disease (MRD) assessment for stage II colorectal cancer (CRC).

MRD assessment is evolving in CRC, says Hubbard. For example, patients with stage III CRC who are MRD negative may still experience disease recurrence, Hubbard explains. Patients with stage III disease or stage II disease who presented with large tumors, or perforation or obstruction, should be treated with adjuvant therapy because they are at a high risk of recurrence, says Hubbard. Patients with low-risk disease who are typically microsatellite instability­–high likely don’t require adjuvant treatment, Hubbard says.

However, how to optimally treat patients with stage II, intermediate-risk CRC remains unknown, and data have not demonstrated a significant benefit to giving this patient subset adjuvant therapy, Hubbard says. As such, utilizing circulating tumor DNA technology to assess for MRD could allow for more informed treatment decisions in this patient population, concludes Hubbard.