PRECISION-MRD: Prospective Observational Study of Biomarker-Directed Systemic Therapy for Colorectal Cancer Patients with Minimal Residual Disease

Inclusion Criteria

• * Male or female subjects aged >= 18 years * Histologically or cytologically confirmed diagnosis of colorectal adenocarcinoma * Stage II-IV disease per current AJCC staging criteria with no definitive radiographic evidence of disease following locoregional treatment. Small indeterminate lesions measuring =< 10 mm may be permitted at the discretion of the principal investigator * Presence of one of the following targetable biomarkers on tumor or blood molecular testing: BRAF V600E mutation (Cohort A), KRAS G12C mutation (Cohort B), MSI-H status (Cohort C), and HER2 amplification (Cohort D) * Positive ctDNA blood test obtained >= 21 days after surgery or last administration of adjuvant therapy * Prescribed one of the following standard-of-care targeted therapy regimens: BRAF V600E Inhibitor + anti-EGFR antibody for BRAF V600E-mutated tumors, KRAS G12C Inhibitor + anti-EGFR antibody for KRAS G12C-mutated tumors, anti-PD-1 antibody +/- anti-CTLA-4 antibody for MMRd/MSI-H tumors, or anti-HER2 therapies for HER2 amplified tumors

Exclusion Criteria

• * Prior exposure to the following classes of biomarker-directed therapies: BRAF V600E inhibitors, anti-EGFR antibodies, KRAS G12C inhibitors, anti-PD-1/PD-L1 antibodies, anti-CTLA-4 antibodies, or anti-HER2 therapies * Presence of a concurrent malignancy requiring active treatment * Inability to provide informed consent