Circulating Tumor DNA Testing in Predicting Treatment for Patients With Stage IIA Colon Cancer After Surgery

Exclusion Criteria

• •Colon cancer histology other than adenocarcinoma (i.e., neuroendocrine carcinoma, sarcoma, lymphoma, squamous cell carcinoma, etc.).
• •Pathologic, clinical, or radiologic evidence of overt metastatic disease. This includes isolated, distant, or non-contiguous intra-abdominal metastases, even if resected (including the presence of satellite nodules constituting N1c disease in the absence of lymph node involvement).
• •Tumor-related bowel perforation.
• •History of prior invasive colon malignancy, regardless of disease-free interval.
• •History of organ transplantation.
• •Any prior systemic chemotherapy, targeted therapy, or immunotherapy; or radiation therapy administered as treatment for colorectal cancer (e.g., primary rectal adenocarcinomas for which treatment with neoadjuvant chemoradiation is warranted are not permitted).
• •Other invasive malignancy within 5 years before randomization. Exceptions are colonic polyps, non-melanoma skin cancer or carcinoma-in-situ including those of the cervix and breast (DCIS).
• •Synchronous primary rectal and/or colon cancers.
• •Antineoplastic therapy (e.g., chemotherapy, targeted therapy, or immunotherapy) within 5 years before randomization. (For the purposes of this study, hormonal therapy is not considered chemotherapy.).
• •Uncontrolled cardiac disease, in the opinion of the treating medical oncologist, that would preclude the use of any of the drugs included in the GI005 treatment regimen. This includes but is not limited to:
• •* Clinically unstable cardiac disease, including unstable atrial fibrillation, symptomatic bradycardia, unstable congestive heart failure, active myocardial ischemia, or indwelling temporary pacemaker.
• •* Ventricular tachycardia or supraventricular tachycardia that requires treatment with class Ia antiarrhythmic drugs (e.g., quinidine, procainamide, disopyramide) or class III antiarrhythmic drug (e.g., sotalol, amiodarone, dofetilide). Use of other antiarrhythmic drugs is permitted.
• •* Second- or third-degree atrioventricular (AV) block unless treated with a permanent pacemaker.
• •* Complete left bundle branch block (LBBB) unless treated with a permanent pacemaker.
• •Sensory or motor neuropathy \>= grade 2, according to Common Terminology Criteria for Adverse Events (CTCAE) version (v) 5.0.
• •Active seizure disorder uncontrolled by medication.
• •Active or chronic infection requiring systemic therapy.
• •Known homozygous DPD (dihydropyrimidine dehydrogenase) deficiency.
• •Pregnancy or lactation at the time of randomization.
• •Co-morbid illnesses or other concurrent disease that, in the judgement of the clinician obtaining informed consent, would make the patient inappropriate for entry into this study (i.e., unable to tolerate 6 months of combination chemotherapy or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens or prevent required follow-up).
• •Prior testing with any available ctDNA test as part of the management of colon cancer, is not permitted.