ctDNA as risk stratifying biomarker in stage III and IV Wilms tumor

The utility of circulating tumor DNA as risk stratifying biomarker in patients with Wilms tumor (WT) has not been established. Analysis of results of the Children’s Oncology Group AREN0533 found that ctDNA was detected in the pretreatment serum of 41 of 50 (82%) of WT stage III or IV patients. Agreement between serum ctDNA and tumor sequencing results was 77% for 1q gain, 88% for 16q deletions, and 70% for 1p deletions. Single-nucleotide variants detected in tumors could be identified in ctDNA. Detection of ctDNA was associated with a trend towards worse EFS and OS. All recurrences and deaths occurred in patients who had detectable levels of ctDNA at the time of diagnosis.