JCO precision oncology最新文献

{"title":"Artificial Intelligence-Powered Human Epidermal Growth Factor Receptor 2 Quantification and Clinical Outcomes in Human Epidermal Growth Factor Receptor 2-Positive Biliary Tract Cancer Treated With Trastuzumab Plus Folinic Acid, Fluorouracil, and Oxaliplatin.","authors":"Hongsik Kim, Chiyoon Oum, Soo Ick Cho, Wonkyung Jung, Hong Jae Chon, Myung Ah Lee, Hyeon-Su Im, Min Hwan Kim, Taekjin Nam, Chan-Young Ock, Hye Jin Choi, Choong-Kun Lee","doi":"10.1200/PO-25-00510","DOIUrl":"https://doi.org/10.1200/PO-25-00510","url":null,"abstract":"<p><strong>Purpose: </strong>Despite recent advances in anti-human epidermal growth factor receptor 2 (HER2) treatments for HER2-positive biliary tract cancer (BTC), current guidelines lack clear thresholds for defining HER2 positivity in BTC. This study investigated the use of artificial intelligence (AI) to analyze HER2 expression and immune phenotypes (IP) in patients with HER2-positive BTC treated with anti-HER2 therapy.</p><p><strong>Materials and methods: </strong>We conducted a post hoc analysis of a phase II trial (KCSG HB19-14) of trastuzumab plus folinic acid, fluorouracil, and oxaliplatin (FOLFOX) for HER2-positive BTC. AI-powered HER2 quantification and IP analyses were performed on whole-slide images of pretreatment samples. Clinical outcomes were analyzed on the basis of HER2 positivity using a continuous AI-based HER2 immunohistochemistry scoring system. Additionally, we evaluated the spatial distribution of tumor-infiltrating lymphocytes using AI-based IP analysis.</p><p><strong>Results: </strong>Among 29 patients, the overall concordance rate between pathologists and the HER2-AI analyzer was 79.1%. AI-defined HER2-positivity status, characterized by a ≥30% H3 tumor cell proportion threshold, significantly predicted improved outcomes with trastuzumab plus FOLFOX (progression-free survival: 6.7 <i>v</i> 4.9 months, <i>P</i> = .039; overall survival: not reached <i>v</i> 8.4 months, <i>P</i> = .018). By contrast, traditional pathologist-based scoring did not stratify outcomes. AI-powered immune profiling revealed that HER2 3+ tumors predominantly exhibited immune-desert phenotypes, whereas HER2 2+ tumors displayed more inflamed phenotypes, potentially limiting the efficacy of current immunotherapy regimens for HER2 3+ BTC.</p><p><strong>Conclusion: </strong>AI-powered HER2 quantification provides a refined biomarker for predicting the response to HER2-targeted therapies in BTC, proposing a ≥30% HER2 3+ tumor cell proportion threshold. Our findings highlight the potential of combining anti-HER2 therapy with immune checkpoint inhibitors on the basis of IP profiles.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500510"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dihydropyrimidine Dehydrogenase-Guided Dosing of 5-Fluorouracil: Prioritizing Precision Over Dose Reduction.","authors":"Govind Kallee, Gerard Milano, Joseph Ciccolini","doi":"10.1200/PO-25-00657","DOIUrl":"https://doi.org/10.1200/PO-25-00657","url":null,"abstract":"","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500657"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactive Use of Cox Model-Predicted Survival Curves: An Application Using ACS10 Score and Age to Personalize Treatment of Pediatric AML.","authors":"Subodh Selukar, Harrison Clement, Yonghui Ni, Huiyun Wu, Tushar Patni, Anna Eames Seffernick, Hiroto Inaba, Raul Ribeiro, Jatinder Lamba, Yimei Li, Stanley Pounds","doi":"10.1200/PO-25-00634","DOIUrl":"https://doi.org/10.1200/PO-25-00634","url":null,"abstract":"<p><strong>Purpose: </strong>Analyses in oncology frequently include Cox proportional hazards models for survival outcomes, but reported results typically only include hazard ratios and respective inference. Cox model predictions of survival functions may help to provide a greater clinical meaning from fitted Cox models for precision oncology research.</p><p><strong>Patients and methods: </strong>We created a publicly available software library, shinyCox, that can generate user-friendly interactive applications to visualize survival outcome predictions of fitted Cox models. To illustrate the benefits of this software, we analyzed data from AML02 and AML08, randomized clinical trials for pediatric patients with AML. Building on a recent article, we assessed how baseline factors and a pharmacogenomics score (ACS10) can affect the predicted overall survival (OS) and event-free survival (EFS) between patients assigned to induction regimens of clofarabine plus cytarabine or daunorubicin and etoposide combined with low-dose cytarabine or high-dose cytarabine.</p><p><strong>Results: </strong>Our model outcome prediction visualization application highlights previously reported associations of ACS10 with EFS and OS, while also providing a better understanding of how other prognostic factors amplify or mitigate prognostic implications of ACS10. It is informative to better understand the practical clinical outcomes in terms of predicted survival probabilities to complement the insights gained from hazard ratio tables.</p><p><strong>Conclusion: </strong>Using shinyCox, we generated visualization applications that let us identify complex relationships between the ACS10 score, age, and the predicted OS and EFS probabilities after AML therapy. This article shows how shinyCox will facilitate model interpretation and accelerate the development of personalized therapies in oncology.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500634"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transgender and Gender-Diverse Patient Perspectives on Hereditary Breast Cancer Risk Assessment in Gender-Affirming Top Surgeries.","authors":"Kimberly Zayhowski, Kai Blumen, Kathleen F Mittendorf, Rebekah Pratt, Carl Streed, Tala Berro, Ian M MacFarlane","doi":"10.1200/PO-25-00037","DOIUrl":"https://doi.org/10.1200/PO-25-00037","url":null,"abstract":"<p><strong>Purpose: </strong>Transgender and gender-diverse (TGD) people have increased cancer morbidity and mortality relative to cisgender individuals. Existing breast cancer prevention guidelines fail to adequately address gender-affirming care implications, especially in the context of gender-affirming mastectomies (top surgery). Evaluation of familial and germline genetic risk before top surgery is recommended by some transgender health guidelines. This evaluation can facilitate shared surgical decision making regarding breast tissue resection extent. In this study, we use in-depth interviews with TGD people planning or having recently undergone top surgery. We aimed to understand barriers and facilitators to pre- and post-top surgery breast cancer risk assessment and screening, and the perceived utility and acceptability of presurgical genetic evaluation.</p><p><strong>Methods: </strong>We conducted qualitative community-engaged research through interviews with 16 TGD adults who had or were considering top surgery. Through a social constructivist lens, we used reflexive thematic analysis to generate themes.</p><p><strong>Results: </strong>We conceptualized six key themes: (1) post-top surgery cancer screening uncertainty, (2) lack of provider knowledge hindering appropriate care, (3) the experience of breast health spaces as heavily feminized, (4) the balance of aesthetic goals with cancer risk reduction, (5) increased comfort with postsurgical screening because of reduced dysphoria and greater body confidence, and (6) the desire for cancer genetics integration with top surgery care navigation.</p><p><strong>Conclusion: </strong>From these themes, we derived actionable guidance to address breast cancer health equity in this population. Enhancing patient education, increasing provider awareness, and developing inclusive clinical practice guidelines are crucial steps in effectively addressing breast cancer risk in individuals receiving surgery. It is vital to degender health spaces to promote inclusion and accessibility of breast cancer prevention. Integrating genetics professionals and cancer risk assessment into transgender health clinics and the top surgery process is paramount for delivering personalized care and facilitating informed surgical decision making.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500037"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Dihydropyrimidine Dehydrogenase Enzyme-Guided Dosing of 5-Fluorouracil: Prioritizing Precision Over Dose Reduction.","authors":"Helle-Brit Fiebrich-Westra, Christina Haroun, Remco van der Galiën, Daphne den Besten-Bertholee, Maarten J Deenen, Dirk Jan A R Moes, Pierre M Bet, Jan Willem B de Groot, Richard M Brohet, André B P van Kuilenburg, Jan Gerard Maring","doi":"10.1200/PO-25-00758","DOIUrl":"https://doi.org/10.1200/PO-25-00758","url":null,"abstract":"","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500758"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Germline and Somatic <i>BRCA1/2</i> Mutations in Breast Cancer Treatment Strategies.","authors":"Yakup Ergun","doi":"10.1200/PO-25-00383","DOIUrl":"https://doi.org/10.1200/PO-25-00383","url":null,"abstract":"","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500383"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Genetic Predisposition to Inflammation With Cancer-Related Cognitive Impairment and Fatigue in Women Who Received Chemotherapy for Nonmetastatic Breast Cancer.","authors":"Ayokunle S Olowofela, Paul L Auer, Michelle Janelsins, Karen Mustian, Alison Conlin, Adedayo A Onitilo, Marianne Melnik, Chin-Shang Li, Umang Gada, Hongying Sun, Sarah L Kerns","doi":"10.1200/PO-25-00303","DOIUrl":"10.1200/PO-25-00303","url":null,"abstract":"<p><strong>Purpose: </strong>Cancer-related cognitive impairment (CRCI) and cancer-related fatigue (CRF) are reported by approximately 75% of patients receiving chemotherapy for breast cancer and both have been linked to inflammation. We sought to test whether an inflammation polygenic risk score (iPRS) might be associated with CRCI and/or CRF.</p><p><strong>Methods: </strong>Using data from the UK Biobank, we developed an iPRS for the INFLA-Score, a composite measure of C-reactive protein, white cell count, platelet count, and neutrophil-lymphocyte ratio. The iPRS was evaluated for association with CRCI and CRF among women with nonmetastatic breast cancer enrolled in two completed multisite clinical trials: URCC08106 and URCC10055. CRCI and CRF were measured before and after standard-of-care chemotherapy using the FACT-Cog and Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF), respectively. Linear regression evaluated the change in FACT-Cog and MFSI scores; logistic regression evaluated binary outcomes of any versus no worsening of scores. Analyses were adjusted for patient and treatment factors. We also performed exploratory genome-wide analyses.</p><p><strong>Results: </strong>The cohort included 802 women who received chemotherapy (anthracycline-based = 51.8%; previous surgery = 85.0%) at a median age of 55 years (range = 22-81). The iPRS was associated with a significant decrease in MFSI-SF score (β = -3.29 [95% CI, -6.25 to -0.34]; <i>P</i> = .029) and lower odds of decreased MFSI-SF score (odds ratio, 0.66 [95% CI, 0.47 to 0.93]; <i>P</i> = .016) following chemotherapy. This negative relationship was partially explained by a positive correlation of the iPRS with prechemotherapy MFSI-SF score (β = 4.33 [95% CI, 0.23 to 8.43]; <i>P</i> = .038). The iPRS was not associated with a change in FACT-Cog score (β = -1.12; <i>P</i> = .627), but single nucleotide polymorphism rs9365961 was (β = -10.05; <i>P</i> = 1.46 × 10^-8).</p><p><strong>Conclusion: </strong>If validated, the iPRS could identify patients in need of supportive care interventions to reduce CRF.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500303"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Significance of <i>RB1</i> Alterations on Outcomes in Metastatic Prostate Cancer.","authors":"Ruben Raychaudhuri, Isla P Garraway, Kara N Maxwell, Matt Rettig, Heena Desai, Martin W Schoen, Michael T Schweizer, Himisha Beltran, Peter S Nelson, Bruce Montgomery","doi":"10.1200/PO-25-00341","DOIUrl":"10.1200/PO-25-00341","url":null,"abstract":"<p><strong>Purpose: </strong>Emerging evidence suggests that <i>RB1</i> inactivation may be a strong predictor of poor survival for men with prostate cancer (PC); however, large-scale validation is lacking.</p><p><strong>Methods: </strong>We analyzed whether <i>RB1</i> alterations are associated with inferior survival in advanced PC and evaluated the impact of co-occurring genomic alterations on outcomes using retrospective data from the Veteran's Health Administration and Veterans Affairs Multi-Omics Analysis Platform for Prostate Cancer from 2016 to 2023.</p><p><strong>Results: </strong>The primary outcome was overall survival (OS) from onset of metastatic castration-resistant prostate cancer (mCRPC), as well as OS from initiation of life-prolonging therapy other than androgen deprivation therapy, and time to development of mCRPC. Eighty-seven (3.5%) of the 2,512 included patients had an <i>RB1</i> alteration detected. The median age at diagnosis in the <i>RB1</i>-altered group was 71 (IQR, 65-76) years, and 68 (IQR, 62-73) years in the <i>RB1</i> wild-type group. The median overall survival from diagnosis of mCRPC was 1.31 years (95% CI, 0.89 to 1.84) in those with an <i>RB1</i> alteration compared with 2.99 years (95% CI, 2.79 to 3.23). <i>RB1</i> alteration alone conferred similar poor prognosis when compared with patients who had combined <i>PTEN</i> and <i>TP53</i> alterations. A dose effect was seen with increasing numbers of tumor suppressor genes (TSGs-<i>RB1</i>, <i>TP53</i>, and <i>PTEN</i>) conferring poorer outcomes. The median survival of patients from diagnosis of mCRPC with zero, one, two, and three TSGs was 3.74, 2.61, 1.61, and 0.87 years, respectively. <i>BRCA2</i> alterations were not associated with significantly worse outcomes unless accompanied by <i>RB1</i> alteration.</p><p><strong>Conclusion: </strong>In this large, real-world cohort of men with mCRPC, <i>RB1</i> alterations emerged as a strong indicator of poor prognosis and can be used to stratify studies alone or in conjunction with other TSG alterations.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500341"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Outcomes From Males Regarding Germline Testing for Prostate Cancer: Results From the PROGRESS Registry.","authors":"Stacy Loeb, Scott W Keith, Laura Gross, Rebecca L Hartman, Tomasz M Beer, Karina L Brierley, Heather H Cheng, Anna Couvillon, Adam P Dicker, Sue Friedman, Leonard G Gomella, Lawrence Karsh, William K Kelly, Costas D Lallas, Amy E Leader, Mark J Mann, James Ryan Mark, Patrick Mille, Channing J Paller, Huma Q Rana, Alexandra O Sokolova, Edouard J Trabulsi, Young E Whang, Veda N Giri","doi":"10.1200/PO-25-00571","DOIUrl":"10.1200/PO-25-00571","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate cancer (PCA) germline testing (GT) informs precision therapy, cancer screening, and hereditary cancer risk for patients and families. To support patient-centered PCA GT, studying patient-reported outcomes (PROs) is essential.</p><p><strong>Methods: </strong>PROGRESS was a national patient-driven registry (January 2021-April 2022) for English-speaking males older than 18 years with previous/current PCA GT and Internet access. Surveys collected demographics, PCA history, family cancer history, mode of genetics care delivery, satisfaction with genetic counseling, decisional conflict, cancer genetics knowledge, and attitudes toward GT. Multiple linear regression modeling was used to estimate and draw inferences (α = .05) on strength of relationships between participant characteristics and PROs.</p><p><strong>Results: </strong>Analyses focused on 414 participants: White (88%), Black (3%), Asian (6%), and mixed/other (3%). Most participants were non-Hispanic (95.2%) and 46.9% had PCA. Genetic results were positive (pathogenic/likely pathogenic variants; mutations) in 27.9%. The three most common modes of genetics care were meeting with genetics professional (in-person or remotely; 30.9%), discussing with doctor (21.1%), and using website (20.8%). In covariate-adjusted models, satisfaction scores were highest with pretest counseling by phone (β = 1.31; 95% CI, 0.26 to 2.36) or discussion with doctor (β = 1.25; 95% CI, 0.38 to 2.12). Lower decisional conflict scores were reported for pretest counseling by phone (β = -3.76; 95% CI, -7.28 to -0.24). Males with mutations reported higher GT benefit scores (β = .30; 95% CI, 0.02 to 0.59) and importance of GT (β = .34; 95% CI, 0.08 to 0.61). Asian Americans reported lower GT satisfaction (β = -2.91; 95% CI, -4.34 to -1.48) and higher decisional conflict (β = 8.93; 95% CI, 4.36 to 13.51).</p><p><strong>Conclusion: </strong>PROGRESS Registry informs the first comprehensive report of PROs among males undergoing PCA GT, providing insights into opportunities to improve patient experience and leverage the benefit of GT.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500571"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Circulating Tumor DNA-Based Molecular Residual Disease Detection for Postoperative Monitoring in Early-Stage Uterine Cancer.","authors":"Peter W Ketch, Carly Bess Scalise, Fernando Recio, Tara Berman, Nicole Hook, Paul Loar, Rebecca Arend, Punashi Dutta, Zach Gentry, Ekaterina Kalashnikova, Meenakshi Malhotra, Minetta C Liu, Luis Vaccarello, Adam C ElNaggar, Robert Holloway, Michael D Toboni","doi":"10.1200/PO-25-00286","DOIUrl":"10.1200/PO-25-00286","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical decision making for adjuvant treatment in early-stage uterine cancer (UC) following surgery is typically directed by clinicopathological risk factors. There is an unmet need for a clinically relevant biomarker to improve individualized risk stratification and help monitor response to adjuvant therapy. Here, we sought to analyze circulating tumor DNA (ctDNA) as a prognostic biomarker in patients with early-stage UC.</p><p><strong>Methods: </strong>Retrospective analysis of ctDNA results from real-world data was performed for 61 patients (233 plasma time points) diagnosed with early-stage UC. ctDNA status and dynamics were assessed using a clinically validated, personalized, tumor-informed ctDNA assay (Signatera), and its association with recurrence-free survival (RFS) was evaluated.</p><p><strong>Results: </strong>ctDNA positivity was associated with significantly reduced RFS postoperatively (hazard ratio [HR], 7.6; <i>P</i> = .003) and postdefinitive therapy (HR, 25.4; <i>P</i> = .0009) and was the most significant factor associated with recurrence when compared with other clinicopathological and molecular risk factors. Notably, of patients who recurred and for whom clinical outcomes were available, 100% were ctDNA-positive before or at the time of recurrence, whereas none of the serially ctDNA-negative patients experienced relapse.</p><p><strong>Conclusion: </strong>Our data demonstrate the feasibility of monitoring ctDNA in the postoperative and adjuvant settings in early-stage UC. Analysis of ctDNA, in addition to other risk factors, may help identify patients at the highest risk of recurrence, inform surveillance strategies, and support treatment decision-making for these patients.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500286"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}