Circulating tumor DNA dynamics predict pathological response and guide therapy personalization in the neoadjuvant...

Area of Science:

• Oncology
• Molecular Diagnostics
• Biomarker Research

Background:

• Neoadjuvant therapy assessment is traditionally delayed, leading to a "black box" period with potential for ineffective or toxic treatments.
• Circulating tumor DNA (ctDNA) is emerging as a dynamic biomarker for real-time monitoring of tumor burden.

Purpose of the Study:

• To review the potential of ctDNA as a dynamic biomarker in neoadjuvant therapy.
• To explore how ctDNA dynamics predict treatment response and survival across various solid tumors.

Main Methods:

• Review of existing literature on ctDNA dynamics in neoadjuvant settings.
• Analysis of ctDNA clearance kinetics and their correlation with pathological response and survival outcomes.

Main Results:

• Serial ctDNA monitoring via liquid biopsies provides non-invasive, real-time assessment of tumor burden.
• Rapid ctDNA clearance predicts favorable outcomes and supports treatment de-escalation.
• Persistent ctDNA identifies non-responders, indicating potential benefit from therapy intensification.

Conclusions:

• ctDNA dynamics are powerful predictors of neoadjuvant treatment efficacy and patient survival.
• Challenges like assay standardization and low-shedding tumors need addressing for clinical adoption.
• Integrating ctDNA with other data using AI can personalize neoadjuvant care, optimizing efficacy and minimizing toxicity.