The purpose of this study is to see if early treatment of your metastatic colorectal cancer and circulating tumor DNA (ctDNA) positivity or negativity, with FOLFIRI, Nivolumab or Encorafenib /Binimetinib/ Cetuximab, helps to prevent stage IV disease. 

After initial adjuvant chemotherapy, it is standard for individuals to begin active surveillance, where they do not receive further treatment but instead undergo frequent tumor imaging scans to see if their cancer is stable, growing, or coming back. We plan to see if additional therapy, where FOLFIRI (comprised of Irinotecan, Leucovorin, and 5-Fluorouracil), Nivolumab or Encorafenib /Binimetinib/ Cetuximab, is administered and can decrease recurrence of metastatic colorectal cancer.

   
   In this study we are looking to determine whether:

1. There are differences in cancer recurrence in ctDNA positive participants treated with additional therapy versus put on active surveillance

2. There are differences in health in ctDNA positive participants treated with additional therapy versus being put on active surveillance