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Detection and Monitoring of Tumor Associated Circulating DNA in Patient Biofluids
Published on: June 8, 2019
Bayesian secondary reanalysis of published aggregate data on circulating tumor DNA for molecular residual disease
Shugo Yajima1,2, Soichiro Yoshida2, Wei Chen2
1Department of Urology, National Cancer Center Hospital East, Chiba, Japan.
Annals of Clinical Biochemistry
|July 23, 2026
Summary
Circulating tumor DNA (ctDNA) testing for molecular residual disease (MRD) effectively predicts cancer recurrence. Longitudinal monitoring of ctDNA-MRD shows higher sensitivity for detecting recurrence risk compared to single time-point testing.
Area of Science:
- Oncology
- Molecular Diagnostics
- Biostatistics
Background:
- Circulating tumor DNA (ctDNA) testing for molecular residual disease (MRD) is a promising tool for estimating cancer recurrence risk post-treatment.
- Existing aggregate data provides an opportunity for robust reanalysis of prognostic and diagnostic performance.
Purpose of the Study:
- To conduct a Bayesian secondary reanalysis of published aggregate data.
- To estimate the prognostic and diagnostic performance of ctDNA-MRD testing.
Main Methods:
- Utilized Bayesian normal-normal hierarchical models for log hazard ratios of recurrence.
- Employed logit-scale random-effects models for sensitivity and specificity analyses.
- Extracted data from 80 studies across 11 cancer types (Zheng et al.).
Main Results:
- Pooled hazard ratio for recurrence with ctDNA positivity was 7.5 (95% CrI, 6.4-8.8).
- Pooled sensitivity was 57.6% (95% CrI, 53.2-61.9) and specificity was 90.5% (95% CrI, 88.5-92.3).
- Longitudinal monitoring demonstrated higher sensitivity (73.6%) than landmark testing (50.0%) with similar specificity.
Conclusions:
- The study supports a strong association between ctDNA-MRD positivity and cancer recurrence risk.
- Longitudinal ctDNA-MRD monitoring may enhance detection sensitivity.
- Assay technology comparisons require cautious interpretation due to aggregate, non-head-to-head data.
