Quantitative analysis showed that ctDNA mutations in KRAS, APC, and TP53 genes (41,46) and hypermethylation of multiple genes (APC, GATA binding protein 5 (GATA5), HLTF, hyperpigmentation, progressive, 1 (HPP1), integrin subunit alpha 4 (ITGA4), protocadherin 10 (PCDH10), Ras association domain family member 1 (RASSF1A), SEPT9, short stature homeobox 2 (SHOX2), and secreted frizzled-related protein 2 (SFPR2) are frequently present in patients with late-stage CRC (29,36,46,73,84,89,103,106). This evidence concerns the gene ITGA4 and colorectal carcinoma.