Circulating Tumor DNA Predicts Poor Survival Outcomes in Esophageal Cancer Patients

Strategic Insights -

Cancer Weekly reports a new study on personalized medicine that sheds light on the predictive value of circulating tumor DNA (ctDNA) for monitoring treatment response and predicting outcomes in esophageal cancer patients undergoing neoadjuvant therapy (NAT). Researchers from Shanghai Jiao Tong University School of Medicine conducted a meta-analysis to evaluate the prognostic value of ctDNA in predicting survival outcomes and pathologic complete response (pCR) in esophageal cancer patients.

Key Takeaways:

  • The meta-analysis included 10 observational studies and randomized clinical trials that reported associations between ctDNA detection and progression-free survival (PFS), overall survival (OS), or pCR in esophageal cancer patients.
  • Baseline ctDNA detection was not significantly associated with PFS, OS, or pCR (P 0.05), but ctDNA detection post-NAT and surgery predicted worse PFS, OS, and lower odds of pCR.
  • ctDNA detection following NAT predicted worse PFS (HR 3.81; 95% CI: 2.19-6.64), OS (HR 3.00; 95% CI: 1.64-5.50), and lower odds of pCR (OR 0.26; 95% CI: 0.09-0.73).
  • Similarly, ctDNA detection post-surgery predicted worse PFS (HR 4.17; 95% CI: 2.17-8.04) and OS (HR 4.00; 95% CI: 1.90-8.42).
  • The study concluded that further standardization of ctDNA detection methods is essential to optimize its clinical utility.

Statistics:

  • The meta-analysis included 334 patients from 10 studies.
  • The pooled hazard ratio (HR) for PFS post-NAT was 3.81 (95% CI: 2.19-6.64).
  • The pooled HR for OS post-NAT was 3.00 (95% CI: 1.64-5.50).
  • The pooled odds ratio (OR) for lower pCR post-NAT was 0.26 (95% CI: 0.09-0.73).
  • The pooled HR for PFS post-surgery was 4.17 (95% CI: 2.17-8.04).
  • The pooled HR for OS post-surgery was 4.00 (95% CI: 1.90-8.42).

Sources:

  • NewsRx LLC, "New Personalized Medicine Study Findings Have Been Reported by Researchers at Shanghai Jiao Tong University School of Medicine (Circulating tumor DNA as a biomarker for progression and survival in esophageal cancer after neoadjuvant therapy and ...)", Cancer Weekly, August 26, 2025.
  • International Journal of Surgery, "Circulating tumor DNA as a biomarker for progression and survival in esophageal cancer after neoadjuvant therapy and esophagectomy: a systematic review and meta-analysis", 2025.
  • Tianzheng Shen et al., "Circulating tumor DNA as a biomarker for progression and survival in esophageal cancer after neoadjuvant therapy and esophagectomy: a systematic review and meta-analysis", International Journal of Surgery, 2025.