Predictive Effectiveness of Circulating Tumor DNA in Recurrent Early-Stage Non–Small Cell Lung Cancer: An Updated Meta-Analysis

作者：Di Lu, Nengke Lin, Shaobin Li, Qifan Jing, Jiani C. Yin, Lina Shi, Zilong Zhang, Zhiming Chen, Zhizhi Wang, Tong Yu, Jianxue Zhai, Siyang Feng, Kaican Cai · 发表于：JCO Precision Oncology · 年份：2025 · DOI：10.1200/po-25-00489 · 被引用次数：5 · 研究领域：Cancer Genomics and Diagnostics、Lung Cancer Treatments and Mutations、Lung Cancer Diagnosis and Treatment

PURPOSE Lung cancer remains the leading cause of cancer-related mortality worldwide, with a substantial risk of recurrence even in early-stage non–small cell lung cancer (NSCLC) after curative surgery. Circulating tumor DNA (ctDNA)–based detection of minimal residual disease (MRD) has emerged as a promising tool for identifying patients at increased risk of relapse. However, the predictive effectiveness of ctDNA remains uncertain because of variability in study designs, detection strategies, and statistical power. MATERIALS AND METHODS We conducted a systematic meta-analysis of 30 studies involving 3,287 patients with postoperative NSCLC to evaluate the diagnostic performance of ctDNA-based MRD testing for recurrence detection and survival prediction. Eligible studies were identified through a comprehensive literature search and quality-assessed using the QUADAS-2 tool. Pooled diagnostic estimates were calculated using bivariate random-effects models. Subgroup analyses compared tumor-informed and tumor-agnostic detection strategies at both landmark and longitudinal postoperative time points. RESULTS In landmark analyses, tumor-informed assays demonstrated higher specificity (0.97 v 0.93) and AUC (0.81 v 0.70) than tumor-agnostic approaches, which showed slightly higher sensitivity (0.44 v 0.42). In longitudinal monitoring, the differences narrowed: tumor-informed assays retained higher specificity (0.96 v 0.88), whereas tumor-agnostic methods exhibited modestly higher sensiti...