Cancer Center, The First Hospital of Jilin University, No.1 Xinmin Street, Changchun 130012, China.
Crit Rev Oncol Hematol. 2022 Nov;179:103800. doi: 10.1016/j.critrevonc.2022.103800. Epub 2022 Aug 27.
Circulating tumor DNA (ctDNA) in the bloodstream can be used to reliably identify a minimal residual disease (MRD). ctDNA-MRD has demonstrated clinical values as a predictive and prognostic marker for resectable non-small cell lung cancer (NSCLC) regarding efficacy evaluation, recurrence monitoring, risk classification, and adjuvant treatment choices, and it has the advantage of being non-invasive, real-time, and dynamic. A recent large-scale prospective study of patients with resectable NSCLC revealed that patients with longitudinal undetectable MRD might represent a potentially curable population, benefiting many patients by eliminating wasteful therapies and side effects. However, there are still barriers to using ctDNA-MRD in clinical management, and the most significant is the lack of high-sensitivity detection technologies and consistent detection times. Herein, we defined the clinical significance of ctDNA-MRD in resectable NSCLC, summarized the available next-generation sequencing (NGS) detection approaches, and speculated on future clinical trial design and detection technology optimization.
循环肿瘤 DNA（ctDNA）在血液中可以用于可靠地识别微小残留病灶（MRD）。ctDNA-MRD 作为可切除非小细胞肺癌（NSCLC）的疗效评估、复发监测、风险分类和辅助治疗选择的预测和预后标志物具有临床价值，其优势在于非侵入性、实时性和动态性。最近一项针对可切除 NSCLC 患者的大规模前瞻性研究表明，纵向检测不到 MRD 的患者可能代表一个具有潜在治愈性的人群，通过消除不必要的治疗和副作用，使许多患者受益。然而，ctDNA-MRD 在临床管理中的应用仍然存在障碍，其中最大的障碍是缺乏高灵敏度的检测技术和一致的检测时间。在此，我们定义了 ctDNA-MRD 在可切除 NSCLC 中的临床意义，总结了现有的下一代测序（NGS）检测方法，并对未来的临床试验设计和检测技术优化进行了推测。
