Circulating tumor DNA: A new tool to predict recurrence and guide treatment of colorectal cancer

Circulating tumor DNA (ctDNA) has emerged as a promising biomarker with diverse applications across different stages of colorectal cancer management. One of its primary roles is as a prognostic biomarker for detecting post-surgical molecular residual disease and predicting recurrence risk. Compared to traditional biomarkers and tissue biopsies, ctDNA provides a minimally invasive, dynamic, and comprehensive representation of tumor burden and molecular heterogeneity. However, challenges persist in standardizing ctDNA testing, improving sensitivity for early-stage disease, and ensuring widespread accessibility. In this review, we explore the biological characteristics of ctDNA, the methodologies for its detection, and its broad clinical applications in both localized and metastatic colorectal cancer.