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If a blood test shows no tumour DNA after months of treatment, a trial could test pausing the drug and restarting only when the DNA reappears, giving patients time off without waiting for scans to show growth.
Randomised trials in metastatic disease where patients with sustained ctDNA clearance on therapy are allocated to continued treatment or a monitored treatment holiday with ctDNA-triggered resumption. Endpoints: time to treatment failure, time on treatment, QoL, OS non-inferiority. Distinct from adjuvant ctDNA-guided escalation (DYNAMIC, IMvigor011), this addresses de-escalation in the palliative setting where lead time over imaging gives a safety margin.
Shares IMvigor011, DYNAMIC, Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
Shares Natera, Guardant Health, Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
Shares Natera, Guardant Health, Circulating tumour DNA (ctDNA), Trial design, endpoints and cost.
Shares Natera, Guardant Health, DYNAMIC, Circulating tumour DNA (ctDNA).
Shares Guardant Health, Circulating tumour DNA (ctDNA), Toxicity and quality of life are undervalued, Liquid biopsy (ctDNA).
Shares Availability of evidence of benefits on overall survival and quality of life of cancer drugs approved by European Medicines Agency: retrospective cohort study of drug approvals 2009-13, Circulating tumour DNA (ctDNA), Trial design, endpoints and cost, Colorectal cancer.
Shares Natera, Guardant Health, Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA).
Shares Natera, Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing, Liquid biopsy (ctDNA).