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PRECISION Study Published in ESMO Open Highlights Utility of Guardant360® Liquid and Guardant Reveal® to Assess Recurrence Risk After Surgery for Colorectal Cancer Metastases

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  • ESMO Open published results from the PRECISION study, a prospective multicenter observational trial in Japan involving 130 patients with colorectal cancer metastases.
  • The study evaluated a dual approach pairing pretreatment comprehensive genomic profiling (CGP) with Guardant360 Liquid and postoperative molecular residual disease (MRD) testing with Guardant Reveal.
  • Pretreatment profiling was feasible in nearly all eligible patients, detecting genomic alterations in 97% of participants, with 64% showing profiles associated with a greater than 4-fold higher hazard of recurrence or death.
  • Postoperative MRD detection was evaluable in 99% of surgical patients, with MRD detected in 31% of cases and linked to a 4.7-fold increase in the hazard of recurrence or death.
  • Combining pretreatment genomic profiling with postoperative MRD testing identified three distinct risk groups with estimated two-year recurrence-free survival rates of 78%, 40%, and 9%.
  • The findings suggest that integrating preoperative CGP with postoperative MRD assessment provides complementary prognostic information to guide perioperative treatment strategies for resectable colorectal oligometastases.
  • Establishing the feasibility of this liquid-based dual approach is significant because tissue-based testing is often hindered by limited biopsy accessibility and longer turnaround times.
  • The results indicate potential for developing personalized perioperative chemotherapy for advanced colorectal cancer stages based on reliable biomarkers derived from ctDNA analysis.