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Dynamic Monitoring of Recurrent Ovarian Cancer Using Serial ctDNA: A Real-World Case Series.

Eric Rios-Doria¹, Jonathan B Reichel², Marc R Radke¹

¹Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA.

Current Oncology (Toronto, Ont.)

|October 28, 2025

Summary

Serial circulating tumor DNA (ctDNA) monitoring shows promise for detecting recurrent ovarian cancer (OC) earlier than current methods. While ctDNA offers complementary value to CA-125, further research is needed to address its limitations.

Keywords:

biomarkers circulating tumor DNA ctDNA liquid biopsy minimal residual disease next-generation sequencing ovarian cancer personalized oncology recurrence

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Detection and Monitoring of Tumor Associated Circulating DNA in Patient Biofluids

Detection and Monitoring of Tumor Associated Circulating DNA in Patient Biofluids

Published on: June 8, 2019

Area of Science:

Oncology
Molecular Diagnostics
Biomarker Discovery

Background:

Recurrent ovarian cancer (OC) detection relies on CA-125 and imaging, which have limitations for early identification.
Circulating tumor DNA (ctDNA) analysis presents a potential advancement for monitoring OC recurrence.

Purpose of the Study:

To evaluate the real-world clinical utility of serial ctDNA analysis in patients with recurrent OC.
To compare ctDNA performance against CA-125 levels and radiographic findings.

Main Methods:

Analysis of serial plasma samples (N=23) from six recurrent OC patients.
Utilized a tumor-informed next-generation sequencing assay targeting 68 cancer-related genes.
Correlated ctDNA variant allele frequencies (VAFs) with clinical data.

Main Results:

ctDNA levels generally mirrored clinical status, reflecting disease progression and treatment response.
Rising ctDNA detected recurrence four months prior to clinical indicators in one patient.
Observed discordances between ctDNA and clinical status highlight assay limitations and biological factors.

Conclusions:

Serial ctDNA analysis is a promising biomarker for complementing existing recurrent OC monitoring strategies.
ctDNA can potentially predict relapse and treatment response earlier than current methods.
Further prospective studies are essential to refine ctDNA's clinical utility and integration into personalized OC care.