Population-based cohort study of circulating tumor DNA dynamics as prognostic marker in advanced esophageal squamous cell carcinoma

Esophageal squamous cell carcinoma (ESCC) is a deadly disease with frequent recurrence. There are unmet needs for prognostic biomarkers for dynamically monitoring disease progression and detecting minimal residual disease. A population-based cohort study of 147 patients at the Queen Mary Hospital (Hong Kong) evaluated circulating tumor DNA (ctDNA) as prognostic biomarker for locally advanced or metastatic ESCC recurrence and patient survival. The study found that ctDNA alterations and concentrations were associated with progression-free survival and overall survival. Alteration in postneoadjuvant and postsurgery ctDNA were associated with poor progression-free survival in the curative ESCC group, and NFE2L2 alterations were associated with poor progression-free survival and overall survival in the palliative group. The authors conclude that these findings suggest that longitudinal ctDNA monitoring is useful for detecting minimal residual disease and risk stratification for relapse in patients with ESCC.