Real-world outcomes study of prognostic value of plasma circulating tumor DNA fraction across four common cancer types

Genomic analysis of circulating tumor DNA (ctDNA) is increasingly incorporated into the clinical management of patients with advanced cancer. Beyond tumor profiling, ctDNA analysis also can enable calculation of circulating tumor fraction (TF), which has been found to be prognostic. While most prognostic models in metastatic cancer are tumor-type specific, quantification of TF in ctDNA has the potential to serve as a pragmatic, tumor-agnostic prognostic tool. Analysis of a US nationwide clinico-genomic database found that circulating tumor DNA fraction ≥ 10% was highly correlated with overall survival in mCRPC, mBC, aNSCLC, and mCRC. The authors conclude that with further prospective validation, ctDNA TF could be incorporated into care paradigms to enable precision escalation and de-escalation of cancer therapy based on patient-level tumor biology.