Using Circulating Tumor DNA-Based Molecular Residual Disease Detection for Postoperative Monitoring in Early-Stage...

Area of Science:

• Gynecologic Oncology
• Molecular Diagnostics
• Cancer Biomarkers

Background:

• Adjuvant treatment decisions for early-stage uterine cancer (UC) rely on clinicopathological factors.
• There is a need for biomarkers to improve risk stratification and monitor therapy response in UC.
• Circulating tumor DNA (ctDNA) is being investigated as a potential prognostic tool.

Purpose of the Study:

• To analyze ctDNA as a prognostic biomarker in patients with early-stage UC.
• To assess the association between ctDNA status and recurrence-free survival (RFS).
• To evaluate ctDNA's utility in risk stratification and treatment decision-making for UC.

Main Methods:

• Retrospective analysis of real-world ctDNA data from 61 early-stage UC patients.
• Utilized a personalized, tumor-informed ctDNA assay (Signatera) to assess ctDNA status and dynamics.
• Evaluated the association between ctDNA and RFS using survival analysis.

Main Results:

• Postoperative ctDNA positivity significantly correlated with reduced RFS (HR=7.6, P=.003).
• ctDNA positivity post-definitive therapy showed a strong association with recurrence (HR=25.4, P=.0009).
• 100% of patients who recurred were ctDNA-positive; no ctDNA-negative patients relapsed.

Conclusions:

• Monitoring ctDNA is feasible in the postoperative and adjuvant settings for early-stage UC.
• ctDNA analysis, alongside other factors, can identify patients at high risk of recurrence.
• ctDNA may inform surveillance strategies and support treatment decisions in early-stage UC.