A message from Ylenia Silvestri, Clinical Project Manager

A little over a year after enrolling its first patient, the SAGITTARIUS clinical trial has reached an important milestone. Nearly 300 patients with stage II high-risk or stage III colon cancer have now joined the study, and the trial is actively running across 26 clinical centres in Italy, Spain, and Germany. This progress reflects a shared commitment to advancing post-surgical care for high-risk colon cancer.

From the very beginning, SAGITTARIUS was designed as a collaborative journey where patients, their families, and clinical teams work together. The study’s core innovation – using liquid biopsy to detect minimal residual disease (MRD) after surgery and tumor tissue analysis to identify molecular alterations – guide post-surgical decisions: personalised therapies are considered when MRD is present, while patients without MRD may avoid chemotherapy and the burden of unnecessary side effects.

But innovation in cancer care is meaningful only if it aligns with what matters to patients. That is why SAGITTARIUS places strong emphasis on quality of life, gathering insights into how liquid biopsy–guided strategies influence patients’ physical, emotional, and social well-being, and their overall sense of safety throughout the post-surgical journey. These perspectives are essential to assess whether new approaches may support not only an extended life, but also better day-to-day living.

At the same time, the trial is generating a large and deeply characterised collection of clinical and molecular data on minimal residual disease biology in colon cancer. By integrating tumour tissue genomics with longitudinal ctDNA analysis, SAGITTARIUS offers a unique opportunity to explore how micrometastatic disease evolves, why recurrence happens in some patients but not in others, and which biological features may guide future personalised therapies.

As SAGITTARIUS trial enters its second year, the focus remains clear: to advance scientific and clinical discovery while keeping patients at the centre. Their participation is driving progress toward more personalised and effective post-surgical care, setting the foundation for truly transformative change in colon cancer treatment.