Fig. 1: Study design and overview of computational methods for ctDNA analysis.

We analyzed data from 31 LARC patients treated with NAT. Patients were randomized to receive either INCT-CRT or CRT-CNCT. Patients with a cCR or nCR were enrolled in WW, while the rest underwent TME. Longitudinal WGS data of solid tumors and matched plasma samples were analyzed for ultrasensitive detection and quantification of ctDNA. CRT-CNCT chemoradiation followed by consolidation chemotherapy, ctDNA circulating tumor DNA, cCR clinical complete response, nCR clinical near complete response, INCT-CRT induction chemotherapy followed by chemoradiation, WW watch and wait, TME total mesorectal excision.