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MRD Watch

Sunday, November 15, 2026

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Independent briefing

Molecular residual disease across cancers, one sourced line at a time.

A daily briefing of sourced, fact-only updates on molecular residual disease, ctDNA, and MRD-relevant biomarkers across cancer types. Edited by Alan Tan, a genitourinary hematologist-oncologist. MRD and biomarker items are listed ahead of other news from the same stretch of days.

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Actively accruing studiesHow testing works
Edited by Alan Tan, MD
How a minimal residual disease test worksA tumor sheds DNA fragments into a blood draw and a urine sample. Sequencing finds those tumor fragments among normal DNA. After treatment, the result can read ctDNA detected or not detected.Tumor sheds DNABlood drawUrine sampleTumor DNA stands outTumorNormalAfter treatmentctDNA detectedNot detected

Latest Colorectal and GI items. Open the Colorectal and GI page.

How it works

A clear scan can still miss what is left

Drawn scanNo evidence of diseaseCells a scan does not show
The drawing starts as a clear scan labeled no evidence of disease, then shows small marks for residual cells.

“No evidence of disease” means the scan did not show a tumor. Alan Tan, MD, puts the gap this way, as an illustration rather than a cutoff: “To the human eye, a clear scan can still hide around 200 million cancer cells.” MRD testing, especially ultrasensitive MRD, looks for that leftover signal in blood.

How testing works

Today

Nov 15, 2026 ET

No update is dated today. The latest verified items are below, with MRD and biomarker reports ranked first.

Leading updates

Pinned items, then MRD and biomarker reports, then newer dates.

GIPancreaticPinnedMRD / ctDNABiomarkers

Postoperative Tumor-Informed Circulating Tumor DNA Status for Molecular Residual Disease Detection After Curative-Intent Resection of Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis

A systematic review and meta-analysis of five observational cohorts (237 patients) found that postoperative tumor-informed ctDNA positivity after curative-intent PDAC resection was associated with higher radiological recurrence (RR 2.50, 95% CI 1.90-3.28) and shorter disease-free and overall survival (HRs 8.11 and 5.15); the authors caution that a negative result did not reliably exclude residual disease.

Journal of Gastrointestinal Cancer

Recent

GIColorectalPinnedMRD / ctDNATrials

Natera Announces Clinical Collaboration with Incyte on Interventional Phase II Study in Colorectal Cancer

NCT07823322 (NEXERA-204) is an Incyte-sponsored, not-yet-recruiting, single-arm phase 2 study of INCA33890 in about 40 adults with Signatera-positive, microsatellite-stable stage II/III colorectal cancer after curative resection and chemotherapy, with ctDNA clearance at 3 months as the primary endpoint; Natera announced a clinical collaboration on this study on November 10, 2026.

Natera, Inc.

GIColorectalPinnedMRD / ctDNABiomarkers

Perioperative Circulating Tumor DNA Dynamics in Patients Undergoing Cytoreductive Surgery for Colorectal Peritoneal Metastases

In a single-center series of 87 patients undergoing cytoreductive surgery for colorectal peritoneal metastases, postoperative ctDNA was detectable in 30 of 83 (36%) and was associated with shorter recurrence-free survival (HR 3.5), peritoneal recurrence-free survival (HR 3.1), and overall survival (HR 6.7); the abstract does not name the assay, and the paper is about peritoneal, not liver, metastases.

Annals of Surgical Oncology

OtherPinnedMRD / ctDNAConference data

Signatera Monitoring During First-Line Immunotherapy Showed ctDNA Clearance is Associated with Long-Term Survival Across Four Metastatic Cancers

A Natera press release dated November 5, 2026, describes a real-world SITC analysis of 424 patients on first-line immunotherapy for stage IV melanoma, kidney cancer, MSI-H colorectal cancer, or NSCLC: people with two consecutive negative Signatera results had 36-month overall survival of 93.2% versus 77.9% in all others (HR 0.24, P=0.0003), and among those complete molecular responders overall survival was 93.5% if immunotherapy continued and 89.4% if it stopped (P=0.42). These figures are from the company press release; the official SITC/JITC abstract was not retrieved.

Natera, Inc. company press release

GIColorectalPinnedMRD / ctDNABiomarkers

Risk stratification by circulating tumor DNA-based pretreatment genomic profile and post-operative molecular residual disease detection in resectable colorectal oligometastases: PRECISION, a prospective multicenter study

In the prospective PRECISION study of 118 eligible patients with resectable colorectal oligometastases, pretreatment Guardant360 genomic profiling and postoperative Guardant Reveal MRD were each independently associated with shorter recurrence-free survival (multivariable HRs 3.28 and 4.07); patients with both a poor genomic profile and postoperative MRD had the highest recurrence risk (RFS HR 13.28), and those with an optimal profile and undetected MRD had a 2-year RFS of 77.8%.

ESMO Open

GIColorectalMRD / ctDNATrialsTumor-informed

ALTAIR: trifluridine/tipiracil did not significantly extend DFS after ctDNA turned positive in resected colorectal cancer

In the phase 3 ALTAIR trial published in Nature Medicine on June 8, 2026, 243 patients with resected colorectal cancer who became tumor-informed ctDNA-positive without radiographic disease were randomized to trifluridine/tipiracil or placebo; median disease-free survival was 9.30 versus 5.55 months (HR 0.79; P = 0.107), so the primary endpoint was not met.

Nature Medicine