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- Create Date September 29, 2025
- Last Updated September 30, 2025
Personalizing Therapy in Borderline Rectosigmoid Cancer with Real-Time MRD Tracking
In this compelling case presentation, Dr. Rattiya explores the diagnostic and therapeutic complexities of a patient with rectosigmoid cancer, highlighting the transformative role of circulating tumor DNA (ctDNA) and minimal residual disease(MRD) monitoring using the K-TRACK assay. Faced with ambiguous staging and overlapping features of rectal and sigmoid colon cancer, the clinical team leveraged genomic insights—specifically a KRAS mutation and pre-treatment MRD positivity(VAF 1.17%)—to guide an aggressive, personalized treatment strategy.
Despite a pathologic complete response post-surgery, persistent ctDNA (VAF0.05%) prompted continued adjuvant therapy and pelvic chemoradiation. Ultimately, ctDNA clearance was achieved, only to be followed months later by molecular relapse (VAF 0.78%)—detected well before any radiologic evidence of recurrence. This early warning enabled preemptive intervention with oral chemotherapy and intensified surveillance.
Dr. Rattiya’s case underscores the clinical value of ctDNA-MRD in real-time treatment monitoring, risk stratification, and early relapse detection. Her experience advocates for integrating MRD testing into routine oncology practice, especially in complex or high-risk cases, to enable truly personalized, data-driven cancer care.
