A message from Marianna Vitaloni, Medical and Scientific Project Manager

In recent years, we have witnessed remarkable advances in cancer research, moving us closer to an increasingly personalised approach to medicine. New technologies and biomarkers are transforming the way colon cancer is monitored and treated, with the goal of tailoring therapeutic decisions to the specific characteristics and needs of each individual patient.

Among the most promising developments is the use of circulating tumour DNA (ctDNA), a technology that, among its many potential applications, may help detect minimal residual disease (MRD) and identify patients at higher risk of recurrence after surgery, better define the molecular profile of a tumour, and support more precise and personalised treatment decisions, even in the early stages of colon cancer. In the future, this information may help determine not only which patients are most likely to benefit from adjuvant chemotherapy and which ones can avoid it, reducing unnecessary side effects and their impact on quality of life, but also guide treatment selection based on the biological characteristics of the disease.

This represents a paradigm shift, opening new opportunities for more personalised and potentially less invasive approaches to care. However, as is often the case with innovation, new possibilities also bring new questions.

Within SAGITTARIUS, researchers, clinicians and patient advocates are working together to better understand how ctDNA can support treatment decisions and improve outcomes for people with colorectal cancer. Yet alongside the scientific promise, it is equally important to understand how these innovations are experienced by the people whose lives they are intended to improve.

What does it mean for a patient to receive a positive ctDNA result following what was believed to be curative surgery? What will happen next? How should patients cope with the uncertainty associated with a result that may suggest a risk of recurrence, even when no clinical evidence of disease is visible?

At the same time, a negative ctDNA result may also raise concerns and uncertainties. For some patients, knowing that they may not require adjuvant treatment based on the test result can be reassuring. For others, it may generate anxiety and the feeling that they are “doing less than they should”, particularly while these approaches are still being studied and implemented in clinical practice.

These situations highlight a fundamental reality: a laboratory result is never just a scientific data point. It can shape treatment decisions, influence future plans, affect family relationships and professional activities, and have a profound impact on how patients and their loved ones perceive the future. It extends far beyond clinical outcomes, affecting not only physical and emotional well-being but also the need for support, reassurance and clear information at every stage of the cancer journey.

For this reason, innovation cannot be limited to the development of new technologies alone. It is equally important to understand how these technologies are experienced by patients and how they can be integrated into clinical practice in a clear, equitable and sustainable way.

At Digestive Cancers Europe (DiCE), we believe that innovation should not only be measured by scientific progress, but also by its ability to respond to the real needs, concerns and priorities of patients and their families. Patients need not only access to innovative technologies, but also confidence that there is a clear pathway for interpreting and acting upon the results they receive.

Furthermore, as innovative tools such as ctDNA become more widely available, clinical scenarios will inevitably emerge that may not yet be fully addressed by existing guidelines. Continued generation of scientific evidence, the development of shared recommendations, and effective communication between healthcare professionals and patients will therefore be essential to ensure that treatment decisions are truly informed and shared.

In this context, the patient perspective represents a central component of progress. apatient has a unique story and is the foremost expert in their own lived experience of cancer, including its challenges, fears, priorities and day-to-day realities. Listening to patients’ experiences helps not only to assess the acceptability of new treatment strategies, but also to identify concrete needs, recurring concerns and areas where greater support, communication or clarity may be required.

Within the SAGITTARIUS project, patient involvement and the collection of patient experiences are therefore essential components of the research process. Questionnaires and other data collection tools help us better understand the real-world impact of these emerging strategies on people's lives and contribute to the development of innovation that is not only scientifically robust, but also genuinely centred on patients’ needs.

The personalised medicine of the future cannot be built solely on biomarkers and technological advances. The integration of scientific evidence, clinical expertise and the patient perspective is fundamental to advancing medicine and shaping healthcare systems that are truly centred on people. As we move towards a new era of precision oncology, the future will not be defined solely by what we can measure in a blood sample, but also by how well we understand and respond to the people behind those results.