DAILY: Vitamin D, Aspirin, ExercIse, Low Saturated Fat Foods StudY in Colorectal Cancer Patients With Minimal Residual Disease

Inclusion Criteria:

• Age ≥ 18 years at the time of study entry

• ECOG 0-1

• Histologically documented high-risk stage II, stage III, or stage IV colorectaladenocarcinoma with no evidence of disease following definitive local therapy (including surgical resection or ablation)

• No radiographic evidence of disease by contrast enhanced CT chest/abdomen/pelvis

• Presence of detectable ctDNA mutation that matches mutations found in tumor tissue

• Completion of all standard of care adjuvant therapy

• Platelet count >50,000

• Ability to give informed consent

• Ability to complete all questionnaires involved in study

Exclusion Criteria:

• Concurrent malignancy under active treatment

• Known active gastrointestinal bleeding or peptic ulcer disease

• Known hypersensitivity to vitamin D or aspirin

• CrCl<30 mL/min within 30 days of starting the intervention

• Current usage of therapeutic anticoagulation (warfarin, Eliquis, Xarelto)

• Inability to safely participate in physical activity in the opinion of the treatingoncologist

• Pregnant or nursing women. N.B.: urine pregnancy test will be administered as partof the screening process.

• Persistent hypercalcemia or conditions predisposing to hypercalcemia (i.e.,hyperparathyroidism)

• Known symptomatic genitourinary stones