An interventional study of ctDNA-analysis and Intensified Follow-up Schedule in Colorectal Cancer, Colo-rectal Cancer and ctDNA, sponsored by Claus Lindbjerg Andersen. Active, not recruiting at 10 sites in Denmark. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-29.
Sponsored by Claus Lindbjerg Andersen · Not applicable, Interventional, and Diagnostic
IMPROVE-IT2 is a randomized multicenter trial comparing the outcomes of ctDNA guided post-operative surveillance and standard-of-care CT-scan surveillance. The hypothesis of this study is that ctDNA guided post-operative surveillance combining ctDNA and radiological assessments could result in earlier detection of recurrent disease and identify more patients eligible for curative treatment.
Exclusion Criteria:
ctDNA analysis will be performed every 4 months postoperatively (4, 8, 12, 16, 20 and 24). At time of first positive ctDNA, patients undergo a whole-body FDG-PET/CT-scan for radiological assessment and a colonoscopy. If the initial assessment is without evidence of recurrence, patients will be offered high-intensive radiological surveillance with FDG-PET/CT-scans every 3 months, until recurrence detection or 21 months has passed. At baseline and months 12, 18, 24 and 36 patients complete the QoL questionnaires including EORTC QLQ-C30, fear of cancer recurrence inventory (FCRI), and impact of events scale for cancer (IES-C). At every FDG-PET/CT-scans the patients also complete the questionnaire.
Diagnostic Test: ctDNA-analysis · Other: Intensified Follow-up Schedule
Patients will undergo surveillance according to current Danish Guidelines with CT-scans at months 12 and 36 postoperative and colonoscopy every 5 year until age 75. Longitudinal blood samples will be collected at same time-points as in the experimental group but not analyzed until end of trial. At baseline and months 12, 18, 24 and 36 patients complete the QoL questionnaires including EORTC QLQ-C30, fear of cancer recurrence inventory (FCRI), and impact of events scale for cancer (IES-C).
Minimally-invasive blood-based analysis of circulating tumor DNA (ctDNA).
PET/CT-scans every 3. month
FCI
Fraction of patients with relapse receiving intended curative resection or local treatment aiming at complete tumor destruction as defined at the relevant MDT conference.
Time frame: 5 years
TTCR
Time to clinical recurrence
Time frame: 3 years
3yr-OS
Overall survival at 3 years
Time frame: 3 years
5yr-OS
Overall survival at 5 years
Time frame: 5 years
QoL
Quality of Life by use of EORTC QLQ-C30, version 3.0. The QoL outcome measure is differences in QLQ-C30 score at 12, 24 and 36 months between the experimental and control arm.
Time frame: 3 years
CE
Cost-effectiveness. QoL/Utility weights for the quality-adjusted life years parameter will be QLU-C10D based on EORTC QLQ-C30.
Time frame: 5 years
AR
Adherence rate for patients following ctDNA-guided and standard of care surveillance
Time frame: 3 years
TTMR
Time to molecular recurrence
Time frame: 2 years
FCRI
Fear of Cancer Recurrence Inventory. The FCRI outcome measure is differences in FCRI at 12, 24 and 36 months between the experimental and control arm.
Time frame: 3 years
IES-C
Impact of Events Scale Cancer. The IES-C outcome measure is differences in IES-C at 12, 24 and 36 months between the experimental and control arm.
Time frame: 3 years
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This study is active, not recruiting, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.
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Claus Lindbjerg Andersen