Clinical Applications of Tissue-Free Molecular Residual Disease (MRD) in Colorectal Cancer—Real-World Utilization and Case Series in Asian and Middle Eastern Patients

Background: Despite well-established treatment and follow-up protocols for the management of colorectal cancer patients, recurrences are frequent. Post curative therapy, ctDNA-based molecular residual disease assessment has the ability to stratify patients into higher and lower risks of recurrence. Large-scale clinical trials are necessary to establish utility at a broad level, but physicians also need real-world evidence and case reports before utilizing MRD testing in routine practice. Methods: We analyzed real-world utilization patterns of Guardant Reveal in patients with CRC across stages by collating information from the test request form after the test was ordered as a part of routine practice in the AMEA region. Results: We report that 92% of the tests were utilized for stage II and stage III patients. The timing of the first MRD test order varies between stages, with a higher proportion of tests being ordered within the first 12 weeks of surgery for stage II (71.8%), while for stage III (50%) and stage IV oligometastatic (72%), the first test was ordered after 12 weeks of surgery. Conclusions: Case reports delineate physicians’ perspectives on actions taken on the basis of MRD test results and outcomes.