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Practical recommendations for using ctDNA in clinical decision making.

Stacey A Cohen1,2, Minetta C Liu3, Alexey Aleshin3

  • 1Fred Hutchinson Cancer Center, Seattle, WA, USA. shiovitz@uw.edu.

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|July 12, 2023
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Summary

Circulating tumor DNA (ctDNA) shows promise for early cancer recurrence detection and treatment monitoring. This review offers general recommendations for interpreting ctDNA analysis in clinical practice, particularly for solid tumors.

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Area of Science:

  • Oncology
  • Biomarker Discovery
  • Clinical Diagnostics

Background:

  • Cancer care improvements have reduced mortality.
  • Early detection of recurrence is crucial for effective management.
  • Blood-based biomarkers like circulating tumor DNA (ctDNA) are emerging tools.

Purpose of the Study:

  • To provide general recommendations on the clinical utility of ctDNA.
  • To guide the interpretation of ctDNA analysis in various treatment settings.
  • To clarify the implications, strengths, and limitations of ctDNA in solid tumor patients.

Main Methods:

  • Review of emerging real-world data on ctDNA utility.
  • Analysis of existing observational and indication-specific studies.
  • Synthesis of information to formulate general clinical recommendations.

Main Results:

  • ctDNA is increasingly utilized for detecting molecular residual disease.
  • ctDNA aids in treatment-response monitoring and optimizing surveillance.
  • Evidence suggests ctDNA is a sensitive and specific biomarker for recurrence.

Conclusions:

  • ctDNA holds significant potential in cancer management, particularly for solid tumors.
  • Understanding ctDNA's strengths and limitations is key for clinical application.
  • General recommendations are provided for interpreting ctDNA results in practice.