Pantel and Alix-Panabieres Outline How ctDNA-Guided MRD Detection Could Enable Curative Post-Adjuvant Therapy
This 2024 review argues that ctDNA-based minimal residual disease detection in solid tumours could herald a new era of 'post-adjuvant therapies' aimed at eliminating residual disease before metastatic spread becomes visible on imaging. The authors compare the maturing liquid biopsy MRD paradigm in haematological malignancies with the emerging evidence in solid cancers and identify the key technological and clinical barriers to routine implementation.
The original study
Minimal residual disease as a target for liquid biopsy in patients with solid tumours.
- Authors
- Pantel K, Alix-Panabières C
- Journal
- Nature reviews. Clinical oncology
- Type
- Journal Article, Review
- PMID
- 39609625
Original abstract
Metastasis is the leading cause of cancer-related death in patients with solid tumours. Current imaging technologies are not sufficiently sensitive to detect minimal residual disease (MRD; also known as measurable or molecular residual disease) after initial surgery or chemotherapy, pointing to the need for more sensitive tests to detect remaining traces of cancer in the body. Liquid biopsy, or the analysis of tumour-derived or tumour-induced cells or cellular products in the blood or other body fluids, has opened a new diagnostic avenue to detect and monitor MRD. Liquid biopsy is already used in clinical decision making for patients with haematological malignancies. Here, we review current knowledge on the use of circulating tumour DNA (ctDNA) to detect and monitor MRD in patients with solid tumours. We also discuss how ctDNA-guided MRD detection and characterization could herald a new era of novel 'post-adjuvant therapies' with the potential to eliminate MRD and cure patients before terminal metastatic disease is evident on imaging.