Associate Professor Jeanne Tie, principal investigator of the DYNAMIC-Rectal trial

DYNAMIC-Rectal: Using blood tests to make chemotherapy decisions

The DYNAMIC-Rectal is analysing the presence of circulating tumour DNA (ctDNA) in the bloodstreams of patients with locally advanced rectal cancer treated with curative intent.

The trial’s Principal Investigator, Associate Professor Jeanne Tie, hopes the trial will demonstrate the usefulness of ctDNA blood tests in deciding which patient will or will not require chemotherapy after rectal cancer surgery.

Patients who join the trial will have their ctDNA analysed after they undergo surgery to remove a tumour, and the presence of ctDNA in the bloodstream will be used to determine how likely it is that the tumour will return. The results will then be used to inform the decision about whether a patient will undergo adjuvant chemotherapy – post-operative treatment used to ensure that the primary treatment is effective.

Researchers believe that if ctDNA analysis can be used to determine the risk of cancer recurring, fewer patients will need to undergo adjuvant chemotherapy. Chemotherapy is currently a standard part of treatment after surgery to reduce the risk of tumour recurrence, but if there is no presence of ctDNA in a patients’ bloodstream, then they could be able to safely forgo it.

The trial aims to recruit 408 patients over a period of three years. It is expected to run for five years overall, and will close when the last patient enrolled has had two years of follow-up. The end-goal is for patients with locally advanced colorectal cancer to have ctDNA analysis incorporated into routine clinical practice, to guide treatment decisions.

“We are hoping this helps avoid over-treatment of patients with unnecessary chemotherapy and identify those patients at high risk of recurrence who actually need chemotherapy treatment,” says Associate Professor Tie.

If DYNAMIC-Rectal is successful, then there is greater potential for ctDNA analysis to one day become incorporated into patients’ standard of care.

More information on the DYNAMIC-Rectal trial is available here

Image credit: Walter and Eliza Hall Institute of Medical Research.