anchor "A randomized, double-blind, phase III study comparing trifluridine/tipiracil (FTD/TPI) versus placebo in patients with molecular residual disease following curative resection of colorectal cancer (CRC): The ALTAIR study." J Clin Oncol. 2025;43(4 suppl):LBA22 (CIRCULATE-Japan / EPOC1905; late-breaking abstract, ASCO GI 2025). The escalation arm of the CIRCULATE-Japan platform: patients ctDNA/MRD-positive after curative resection (plus standard adjuvant where applicable) with no radiologic recurrence were randomized to 6 months of FTD/TPI vs placebo. FTD/TPI produced a numerical but NOT statistically significant disease-free survival improvement (median DFS 9.30 vs 5.55 months; HR 0.79, 95% CI 0.60-1.05; P=.107). It bears on the escalation side of the sub-topic's question — what to do once ctDNA is positive — by testing a specific escalation agent in the MRD-positive state; the not-significant result tempers the assumption that escalation in MRD-positive disease yields durable benefit. Caveats: the population is resected CRC broadly (includes resected stage IV, not stage II-restricted), this is a late-breaking abstract pending full publication, and FTD/TPI is not a standard adjuvant regimen — so the bearing on resected stage II colon is via the general MRD-positive escalation principle, not a stage II-specific result.

nod_e898b202-5300-4388-bbd6-7bd389992b74

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