In our exclusive interview, Dr Cohen provided insights into the evolving role of circulating tumor DNA (ctDNA) in clinical decision-making for patients with colorectal cancer (CRC), particularly through findings from the CIRCULATE-Japan GALAXY trial (UMIN000039205). She highlighted how ctDNA has emerged as a strong prognostic factor for recurrence risk in CRC and explored its potential to guide therapy escalation or de-escalation. She also discussed the heterogeneity in the patient population included in the CIRCULATE-Japan GALAXY study and how ctDNA negativity correlates with improved disease-free and overall survival. Additionally, Dr Cohen outlined what data are still needed to integrate ctDNA testing into routine clinical practice and how sustained vs transient ctDNA clearance may influence treatment and surveillance strategies moving forward.