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Did ATOMIC really improve on the standard of care for mismatch repair-deficient colon cancer?
Nature Reviews Clinical Oncology, Published online: 23 April 2026; doi:10.1038/s41571-026-01154-xThe ATOMIC trial has been widely celebrated as providing a positive result. However, when viewed with a lens of critical appraisal that considers issues related to overtreatment, treatment de-escalation, surrogacy, post-trial access to treatment and contributions of component, we argue that ATOMIC should not change clinical practice but rather form the basis for future trials that test de-escalation strategies.
