This study evaluated the association between baseline ctDNA levels and changes in ctDNA during treatment with response and survival outcomes in the phase II ALTER-C-002 trial, which investigated first-line anlotinib combined with capecitabine and oxaliplatin in patients with rat sarcoma (RAS) and B-Raf proto-oncogene (BRAF) wild-type metastatic colorectal cancer. The gene discussed is BRAF; the disease is metastatic colorectal cancer.