ctDNA dynamics monitoring

Overview

Serial ctDNA monitoring tracks changes in circulating tumor DNA variant allele frequencies (VAF) and tumor-matched mutations over time to assess treatment response and predict outcome. Metrics include maxVAF, ctDNA clearance, and change in ERBB2 amplification level PMID:37406106.

Used by

• PMID:41941260 — ctDNA nucleosome positioning used at KIDSROBIN (METEOR center, pediatric arm) to identify candidate radiation-response biomarkers in diffuse midline glioma (DMG) and high-risk neuroblastoma patients PMID:41941260.
• PMID:37406106 — serial ctDNA monitoring (Guardant Health) tracked tumor-matched mutations and ERBB2 amplification in 16 HER2-positive esophagogastric cancer patients on pembrolizumab + trastuzumab + chemotherapy; 12/16 (75%) had declining maxVAF by week 3, of which 75% achieved 6-month PFS vs. 0/4 with rising maxVAF; ctDNA clearance by 9 weeks associated with longer PFS (HR 0.18; 95% CI: 0.06–0.53; P = 0.001) PMID:37406106.
• Post-operative ctDNA detected NSCLC relapse in 13/14 (93%) confirmed-relapse TRACERx cases with median 70-day lead-time over imaging, and tracked adjuvant chemotherapy resistance in real time PMID:28445469

Notes

• Early ctDNA dynamics (3- to 9-week kinetics) outperformed conventional CT response assessment for predicting 6-month PFS in HER2+ EGC PMID:37406106.
• Corpus-grown slug; not present in canonical ontology.

Sources

• PMID:37406106
• PMID:41941260

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