Real-world microscopic residual disease (MRD) monitoring with circulating tumor DNA (ctDNA) in pancreatic adenocarcinoma (PDAC).

作者：Peter Li, Harrison David Winters, Xue Geng, Hongkun Wang, Alan Schumann, Marcus Smith Noel, Aiwu Ruth He, Benjamin A. Weinberg, John Marshall, Anteneh Tesfaye, Reetu Mukherji · 发表于：Journal of Clinical Oncology · 年份：2025 · DOI：10.1200/jco.2025.43.4_suppl.696 · 被引用次数：3 · 研究领域：Cancer Genomics and Diagnostics、Pancreatic and Hepatic Oncology Research、Sarcoma Diagnosis and Treatment

696 Background: ctDNA is a powerful tool that can detect MRD with limited but emerging data in patients (pts) with PDAC. We describe the clinical outcomes of pts with PDAC who underwent real-world MRD testing at our institutions. Methods: We retrospectively analyzed pts at 2 institutions with ≥1 tumor-informed ctDNA test (Natera, Inc) ordered for MRD testing post-operation (post-op) between June 2020-August 2024. Descriptive statistics were used to characterize clinicopathologic factors, ctDNA positivity (ctDNA+), and relapse rates (RR). Median relapse-free survival (mRFS) and overall survival (mOS) were calculated using Kaplan-Meier methods, comparisons between groups by log-rank test, and hazard ratios (HR) by Cox proportional hazard models. Associations between clinicopathologic factors and outcomes were assessed by Fisher’s exact and Chi-square tests. Results: Of the 54 pts who underwent MRD testing, 48 pts (88.9%) had successful tests. Failures were due to insufficient tissue. Patients with successful tests were staged as follows: 31.2% stage 1, 50.0% stage 2, and 18.8% stage 3, with 12.5% having R1/2 resections and 46.8% being node-positive. With a median follow-up of 21.0 months (mo), 22 (45.8%) pts had relapsed and 22 (45.8%) were anytime-ctDNA+. Sensitivity and specificity of ctDNA for relapse was 77.3% and 86.4%, respectively. Between anytime- and never-ctDNA+ pts, RR were 77.0% vs. 23.1%, mRFS 14.2 mo vs. not reached (NR) (HR 4.9, 95% CI 1.9-12.9), and mOS 31.7 mo ...