Optimizing Early-Stage NSCLC Management Through Multidisciplinary Strategies: ASCO 2025 - Episode 10
Clinical Utility of ctDNA in Guiding Perioperative Treatment Decisions in Early-Stage NSCLC
Panelists discuss how circulating tumor DNA (ctDNA) serves as a promising biomarker for identifying patients at higher risk who may benefit from therapy escalation, though they acknowledge the current lack of prospective data on how to act therapeutically on positive ctDNA results.
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ctDNA is emerging as a critical biomarker for tailoring perioperative therapy in early-stage non–small cell lung cancer (NSCLC). Wade Iams, MD, MSCI, explains that persistent ctDNA after neoadjuvant or postoperative therapy is a poor prognostic marker and may justify escalation of treatment.
Despite its prognostic power, the panel agrees that ctDNA lacks sufficient prospective data to guide therapy de-escalation. Longitudinal ctDNA monitoring is gaining traction, especially among surgeons, as a strategy to track recurrence and inform adjuvant treatment duration.
Josh Reuss, MD, and Aditya Juloori, MD, caution that although ctDNA can signal molecular residual disease, there is still uncertainty about how to act on those findings. Ongoing trials and real-world integration will be essential in establishing ctDNA’s clinical utility for improving survival and personalizing NSCLC care.
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