Advances in DNA sequencing methods have significantly expanded the potential clinical applications of analyzing circulating tumor DNA (ctDNA). This genetic information can identify the presence of targetable mutations and has been explored for cancer screening purposes. ctDNA can be obtained without the risks inherent to biopsy, allowing for serial assessments over time. Several studies have additionally suggested that ctDNA can be used to detect the presence of minimal residual disease (MRD) after surgical resection in several cancer types, including lung cancer. The ability to detect MRD would allow clinicians to tailor adjuvant therapies, which carry risks of significant toxicities and may benefit only select groups of patients. Here, we review the current state of ctDNA profiling methods and evaluate the evidence supporting the use of ctDNA analysis to assess for MRD. We discuss how MRD detection could help identify patients at increased risk of disease recurrence and thus guide treatment decisions for resectable lung cancer. Finally, we propose future steps to validate such approaches and expand the utility of these rapidly progressing technologies.

中文翻译：

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在肺癌中使用 ctDNA 检测微小残留疾病：当前证据和未来方向

DNA 测序方法的进步极大地扩展了分析循环肿瘤 DNA (ctDNA) 的潜在临床应用。这种遗传信息可以识别可靶向突变的存在，并已被用于癌症筛查目的。ctDNA 可以在没有活检固有风险的情况下获得，允许随着时间的推移进行连续评估。几项研究还表明，ctDNA 可用于检测包括肺癌在内的多种癌症类型手术切除后是否存在微小残留病灶 (MRD)。检测 MRD 的能力将使临床医生能够定制辅助疗法，这些疗法具有显着毒性的风险，并且可能仅使特定的患者群体受益。这里，我们回顾了 ctDNA 分析方法的现状，并评估了支持使用 ctDNA 分析来评估 MRD 的证据。我们讨论了 MRD 检测如何帮助识别疾病复发风险增加的患者，从而指导可切除肺癌的治疗决策。最后，我们提出了未来的步骤来验证这些方法并扩大这些快速发展的技术的效用。