• Travis K Martin, Aaron Dinerman, Sumedha Sudhaman, Griffin Budde, Charuta C Palsuledesai, Michael Krainock, Minetta C Liu, Emy Smith, Leonidas Tapias, Eitan Podgaetz, and Gary Schwartz.
• Dignity Health East Valley General Surgery Residency, Chandler Regional Medical Center, Chandler, Ariz; Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Ft Worth, Tex. Electronic address: traviskohlmartin@gmail.com.
• J. Thorac. Cardiovasc. Surg. 2024 Jan 18.

ObjectiveThe study objective was to evaluate the impact of monitoring circulating tumor DNA on the detection and management of recurrence in patients with resected early-stage non-small cell lung cancer.MethodsBetween October 2021 and March 2023, postoperative circulating tumor DNA was monitored in patients with non-small cell lung cancer (N = 108). Longitudinal blood samples (n = 378 samples) were collected for prospective circulating tumor DNA analysis at 3-month intervals after curative-intent resection. A tumor-informed assay was used for the detection and quantification of circulating tumor DNA. The primary outcome measure was a circulating tumor DNA-positive result. The secondary outcome measure was changes in practice after a circulating tumor DNA-positive result.ResultsThe mean age of the patients in this cohort was 68.1 years. Of the 108 patients, 12 (11.1%) were circulating tumor DNA positive at least at 1 timepoint postsurgery, of whom 8 (66.7%) had a clinically evident recurrence and the remaining 4 had limited clinical follow-up. Of the 10 patients with recurrent disease, 8 demonstrated circulating tumor DNA positivity and the remaining 2 patients had brain-only metastases. Postoperative clinical care was altered in 100% (12/12) of circulating tumor DNA-positive patients, with 58.3% (7/12) receiving an early computed tomography scan and 100% (12/12) receiving an early positron emission tomography computed tomography scan as part of their surveillance strategy. Among the patients who received an early positron emission tomography scan, 66.6% (8/12) were positive for malignant features.ConclusionsRoutine monitoring of tumor-informed circulating tumor DNA after curative intent therapy improved patient risk stratification and prognostication.Copyright © 2024. Published by Elsevier Inc.

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