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Review
. 2025 Jun 23;13(1):89.
doi: 10.1186/s40364-025-00796-w.

Circulating tumor DNA for MRD detection in colorectal cancer: recent advances and clinical implications

Dening Ma #  1 , Xinyi Gao #  2 , Li Wang  3 , Huan Yin  3 , Longhai Feng  1 , Yuping Zhu  4
Affiliations
Review

Circulating tumor DNA for MRD detection in colorectal cancer: recent advances and clinical implications

Dening Ma et al. Biomark Res. .

Abstract

Circulating tumor DNA (ctDNA)-based molecular residual disease (MRD) provides a powerful approach to predict recurrence in colorectal cancer (CRC) and potentially improve survival outcomes for individuals diagnosed with CRC. Currently, there are two primary technical approaches for the detection of MRD using ctDNA: the tumor-informed assays and the tumor-agnostic assays. Multiple studies have demonstrated the role of MRD detection in CRC patients after radical therapy, including early relapse monitoring, molecular profiling, and treatment response prediction. Numerous interventional clinical trials based on ctDNA are underway to explore the value of MRD in optimizing adjuvant treatment decisions for patients with CRC. Once validated, ctDNA-MRD has the potential to impact current clinical treatment decisions. In this review, we summarize current techniques for detecting MRD based on ctDNA and review the data that have been collected to date on MRD detection in CRC patients who received curative-intent therapy. We also discuss prospective research of ctDNA MRD detection in this patient population and provide guidelines for the current and future use of MRD in clinical practice.

Keywords: Biomarker; Circulating tumor DNA; Colorectal cancer; Molecular residual disease.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not required as this study used public data aggregated on the level of country and global, and no personal information was collected. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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