Research progress in minimal residual disease in locally advanced non-small cell lung cancer / 中华放射肿瘤学杂志

ABSTRACT

For locally advanced unresectable non-small cell lung cancer (NSCLC), the standard regimen is concurrent chemoradiotherapy (CCRT) followed by consolidation immunotherapy. Nevertheless, the majority of patients will experience recurrence. Traditional imaging examination has its limitations of passively identifying recurrence, unable to forecast the risk in advance. Minimal residual disease (MRD) based on circulating tumor DNA (ctDNA) has become a novel tumor biomarker. Existing studies have demonstrated that the levels of ctDNA initially increase and then decrease during CCRT for NSCLC. Monitoring ctDNA-MRD can not only robustly predict recurrence, but also guide the consolidation immunotherapy, evaluate the efficacy and predict clinical prognosis. Furthermore, ctDNA-MRD can be a reliable biomarker to explore other effective treatments. However, few ctDNA-MRD clinical studies related to guiding consolidation therapy have been performed, with small sample size and low-level evidence. The value of ctDNA-MRD still needs to be confirmed by prospective randomized studies.