[MRD Testing in Lung Cancer-Latest Insights and Developments].

Abstract

In lung cancer, circulating tumor DNA(ctDNA)analysis has already been clinically implemented, for example, to detect resistance mutations to EGFR-TKIs. Recently, as in many other cancer types, postoperative detection of molecular residual disease (MRD) has been shown to correlate with poor prognosis. This article summarizes the latest findings on MRD research in lung cancer. A literature review as of May 2024 identified 41 studies on lung cancer MRD. Although no randomized trials have yet utilized MRD to guide treatment decisions in this field, retrospective studies consistently demonstrate its utility in predicting recurrence. In Japan, prospective studies such as JCOG2111A(MRDSEEKER trial, NCT06854939), which evaluates the kinetics and detection rate of MRD using a tumor-informed personalized assay, are currently underway. Notably, recent subset analyses of ctDNA/MRD assessments before and after treatment in randomized trials on perioperative chemoimmunotherapy and adjuvant therapy have garnered significant attention. However, the sensitivity of the assays used in these studies possibly remains suboptimal for lung cancer. Future prospective trials incorporating more sensitive, second-generation assays may be warranted.