{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T02:03:33Z","timestamp":1792893813229,"version":"4.5.0"},"reference-count":22,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"abstract":"\n PURPOSE<\/jats:title>\n We hypothesized that a dynamic surveillance strategy guided by circulating tumor DNA (ctDNA) methylation would increase the rate of curative-intent therapy for recurrence in patients with nonmetastatic colorectal cancer (CRC) after curative resection.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n The FIND trial (ClinicalTrials.gov identifier:\n NCT05904665<\/jats:ext-link>\n ) is a prospective, multicenter, randomized, phase III study. Patients with nonmetastatic CRC were randomly assigned to ctDNA-guided surveillance or standard computed tomography (CT)\u2013based monitoring. In the ctDNA-guided group, a positive ctDNA result triggered immediate CT imaging; if negative, bimonthly CT continued alongside quarterly ctDNA testing. After two consecutive ctDNA-negative results, imaging reverted to standard frequency. The primary end point was the proportion of patients with recurrence receiving curative-intent metastasis-directed therapy.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Among 584 eligible patients (289 ctDNA-guided, 295 control) in the modified intention-to-treat population, with a median follow-up of 23.3 months, recurrence rates were similar (18.0%\n v<\/jats:italic>\n 18.6%,\n P<\/jats:italic>\n = .919). The ctDNA-guided group had a significantly higher rate of curative-intent treatment (48.1%\n v<\/jats:italic>\n 23.6%, relative risk 2.03,\n P<\/jats:italic>\n = .008). The median time to clinical recurrence was significantly shorter in the ctDNA-guided group than in the control group (9.5\n v<\/jats:italic>\n 13.4 months;\n P<\/jats:italic>\n < .001), representing a lead time of 3.9 months. Among recurrences confined to the liver and\/or lungs, the ctDNA-guided group showed higher curative resection rates (42.3%\n v<\/jats:italic>\n 18.2%,\n P<\/jats:italic>\n = .002). These patients had more favorable hepatic metastatic features: fewer lesions (\u22643: 75.0%\n v<\/jats:italic>\n 28.6%,\n P<\/jats:italic>\n = .005), smaller tumor size (\u22643 cm: 90.0%\n v<\/jats:italic>\n 57.1%,\n P<\/jats:italic>\n = .033), and more unilobar disease (80.0%\n v<\/jats:italic>\n 28.6%,\n P<\/jats:italic>\n = .002).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n ctDNA methylation-guided dynamic surveillance improves the rate of curative-intent therapy for recurrence in patients with initially nonmetastatic CRC through earlier detection of resectable metastases, pending validation of long-term survival benefit in future analyses with mature data.<\/jats:p>\n <\/jats:sec>","DOI":"10.1200\/jco-25-03009","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T20:00:21Z","timestamp":1785355221000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":2,"title":["Dynamic Circulating Tumor DNA Methylation Monitoring Guiding Postoperative Surveillance in Nonmetastatic Colorectal Cancer: A Prospective, Randomized, Phase III FIND Trial"],"prefix":"10.1200","clinical-trial-number":[{"clinical-trial-number":"nct05904665","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Shaobo","family":"Mo","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoqiang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"},{"name":"Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China"},{"name":"Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5392-574X","authenticated-orcid":false,"given":"Maoguang","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenqin","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"},{"name":"Department of Pharmacy, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiyuan","family":"Tang","sequence":"additional","affiliation":[{"name":"Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5555-4711","authenticated-orcid":false,"given":"Yaqi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoji","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunliang","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5900-9048","authenticated-orcid":false,"given":"Changhua","family":"Zhuo","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgical Oncology, Fujian Cancer Hospital, College of Clinical Medicine for Oncology, Fujian Medical University, Fujian Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinliang","family":"Jian","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgical Oncology, Fujian Cancer Hospital, College of Clinical Medicine for Oncology, Fujian Medical University, Fujian Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Changshu No. 2 People's Hospital, The Affiliated Changshu Hospital of Nantong University, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhuo","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shangrao People's Hospital, Jiangxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoxia","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Oncology, Xinyu People's Hospital, 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