A recent analysis from a randomized clinical trial conducted by researchers at the Dana-Farber Brigham Cancer Center highlights how the presence of residual cancer in the blood, detected through circulating tumor DNA (ctDNA), can guide treatment decisions for stage 3 colon cancer patients.
The study shows that adding celecoxib, a common anti-inflammatory drug, to standard post-surgery chemotherapy significantly improves outcomes for patients with positive ctDNA tests.
Residual Cancer in the Blood and its Impact
Stage 3 colon cancer is typically treated with surgery to remove the tumor and nearby lymph nodes, followed by adjuvant chemotherapy to reduce the risk of recurrence. Despite these efforts, some patients experience a relapse, making the disease harder to cure.
Recent advances in ctDNA testing, which detects microscopic tumor DNA fragments in the blood, now provide a sensitive method for identifying patients at higher risk of relapse after surgery.
The analysis revealed that patients with positive ctDNA after surgery generally had worse outcomes, indicating the presence of residual cancer. However, this group saw a significant improvement in disease-free survival when celecoxib was added to their treatment.
The Role of Celecoxib
The study builds on earlier research suggesting celecoxib might benefit certain colon cancer patients. In a large clinical trial, the CALGB (Alliance)/SWOG 80702 trial, conducted from 2010 to 2015, 2,526 patients were randomized to receive chemotherapy (FOLFOX) for either three or six months, with or without daily celecoxib for three years.
While the overall benefit of celecoxib was modest and not statistically significant in the general population, this new analysis focused on ctDNA results provides fresh insights.
Researchers revisited data from the trial and analyzed blood samples from 1,011 participants who had agreed to provide blood for research.
Among those with positive ctDNA tests, patients receiving celecoxib alongside chemotherapy had notably better disease-free survival compared to those receiving chemotherapy alone. In contrast, for patients with negative ctDNA, celecoxib showed no added benefit.
A Personalized Approach to Treatment
“This is one of the first studies to demonstrate the predictive utility of ctDNA in identifying patients who may benefit from a specific drug,” said Dr. Jonathan Nowak, a pathologist at Dana-Farber Cancer Institute and Brigham and Women’s Hospital, who presented the findings at the 2025 American Society of Clinical Oncology Gastrointestinal Cancers Symposium.
The results are particularly promising because they suggest a pathway for tailoring treatment to individuals based on their ctDNA status. Patients with positive ctDNA are at higher risk of recurrence, and adding celecoxib to their treatment could help stave off relapse, potentially offering them better outcomes.
Future Implications
“This evidence supports the idea that celecoxib, combined with standard chemotherapy, could be a valuable addition for early-stage colon cancer patients with positive ctDNA,” said Dr. Jeffrey Meyerhardt, senior author and co-director of the Colon and Rectal Cancer Center at Dana-Farber.
“It aligns with previous findings that celecoxib benefits patients with PIK3CA mutations, further emphasizing its role in personalized cancer therapy.”
The researchers believe these findings could help refine treatment strategies for colon cancer, ensuring therapies are targeted to those who would benefit the most. Ongoing studies will further explore the role of celecoxib and other therapies in this context.
Conclusion
This study demonstrates the potential of ctDNA testing to guide post-surgery treatment decisions in stage 3 colon cancer. By identifying patients with residual cancer and tailoring therapy with celecoxib, clinicians may be able to improve outcomes for high-risk individuals.
While more research is needed to confirm these findings and understand the mechanisms involved, this approach represents a promising step toward personalized and more effective cancer care.
If you care about cancer, please read studies that low-carb diet could increase overall cancer risk, and new way to increase the longevity of cancer survivors.
For more information about cancer, please see recent studies about how to fight cancer with these anti-cancer superfoods, and results showing daily vitamin D3 supplementation may reduce cancer death risk.
Copyright © 2025 Knowridge Science Report. All rights reserved.
