What was reported
The National Cancer Center analyzed 5,355 patients in the CIRCULATE-Japan GALAXY observational study. Among patients positive for ctDNA early after surgery, 51.8% met key eligibility criteria for the phase III ALTAIR trial.
A window before imaging recurrence
Among ctDNA-positive patients, 65.2% had no imaging-confirmed recurrence for at least three months after positivity. This may create time for assessment and trial screening, but positivity alone does not confirm recurrence or mandate treatment.
Why serial testing matters
Some patients who were initially negative or unevaluable later became positive. One negative result does not guarantee freedom from future recurrence, and one positive result does not replace imaging, pathology or clinical assessment.
Evidence limits
This was an observational analysis. It does not prove that pre-emptive treatment guided by ctDNA improves survival. Stage, pathology, imaging, CEA and prior therapy remain essential.