Consensus Statement on ctDNA Minimal Residual Disease Testing in Early Stage NSCLC: A Delphi Study by the Asian Thoracic Oncology Research Group

作者：Aaron C. Tan, Bin-Chi Liao, Molly Li, David J Lee, Yuji Uehara, Lucksamon Thamlikitkul, Jia-Tao Zhang, Meimei Zheng, Chee Khoon Lee, Nick Pavlakis, Thomas John, Ross A. Soo, Anders Skanderup, Pei Jye Voon, Beung‐Chul Ahn, Sehhoon Park, Hidetoshi Hayashi, Yasushi Goto, Hidehito Horinouchi, Yasushi Yatabe, Thanyanan Reungwetwattana, James Chih-Hsin Yang, Dong-Wan Kim, Tony Mok, Daniel S.W. Tan, Yi-Long Wu, Myung-Ju Ahn · 发表于：Journal of Thoracic Oncology · 年份：2026 · DOI：10.1016/j.jtho.2026.103696 · 被引用次数：2 · 研究领域：Lung Cancer Treatments and Mutations、Cancer Genomics and Diagnostics、Lung Cancer Diagnosis and Treatment

INTRODUCTION: Minimal residual disease (MRD) detection using liquid biopsy is an emerging tool for risk stratification and monitoring for recurrence in resected early stage NSCLC. There is increasing need for clear guidance on its optimal clinical implementation. METHODS: The Asian Thoracic Oncology Research Group (ATORG) convened a multidisciplinary panel of 27 experts to develop a consensus statement on the clinical application of circulating tumor DNA-based MRD testing in early stage resected NSCLC, using a structured Delphi methodology. Statements were organized into the following broad thematic domains: assay validity and standardization; harmonization in research and trials; clinical application; challenges in implementation; consensus recommendations; infrastructure for regional MRD adoption; and roadmap for pragmatic trials. RESULTS: A total of 23 position statements were developed, of which all except one achieved strong consensus. The consensus highlighted the need to define minimum analytical performance thresholds for MRD assays, improve standardization of reporting metrics, and clear guidelines for pre-analytical handling. Harmonization of blood sampling time points and terminology across clinical trials is also essential to confirm the prognostic value of MRD assays. Although current MRD assays demonstrate high specificity and positive predictive value, variable sensitivity precludes routine use for adjuvant therapy de-escalation outside clinical trials. Broader...