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Practical recommendations for using ctDNA in clinical decision making
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Practical recommendations for using ctDNA in clinical decision making
Practical recommendations for using ctDNA in clinical decision making
Journal Article

Practical recommendations for using ctDNA in clinical decision making

2023
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Overview
The continuous improvement in cancer care over the past decade has led to a gradual decrease in cancer-related deaths. This is largely attributed to improved treatment and disease management strategies. Early detection of recurrence using blood-based biomarkers such as circulating tumour DNA (ctDNA) is being increasingly used in clinical practice. Emerging real-world data shows the utility of ctDNA in detecting molecular residual disease and in treatment-response monitoring, helping clinicians to optimize treatment and surveillance strategies. Many studies have indicated ctDNA to be a sensitive and specific biomarker for recurrence. However, most of these studies are largely observational or anecdotal in nature, and peer-reviewed data regarding the use of ctDNA are mainly indication-specific. Here we provide general recommendations on the clinical utility of ctDNA and how to interpret ctDNA analysis in different treatment settings, especially in patients with solid tumours. Specifically, we provide an understanding around the implications, strengths and limitations of this novel biomarker and how to best apply the results in clinical practice. This Perspective reviews the utility and interpretation of circulating tumour DNA for the detection of residual and recurrent cancers and provides recommendations regarding its clinical application for a variety of solid tumours.