Systematic Review · e0002
Circulating tumor DNA for residual disease and multicancer early detection: a systematic review
Anel Ibrayeva, Batyrbek Assembekov, Yulia Reshetnyak. Circulating tumor DNA for residual disease and multicancer early detection: a systematic review. Global Medical Reviews. 2026;1(1):26–42.
Abstract
Background
Circulating tumor DNA (ctDNA) may guide adjuvant treatment after curative-intent therapy and support multicancer early detection (MCED), but prognostic accuracy and clinical utility are distinct.
Methods
PRISMA 2020 and PRISMA-S guided a narrative synthesis. MEDLINE/PubMed, Embase, Scopus, Web of Science, CENTRAL, trial registries and citation sources were searched to 31 January 2026. Two reviewers screened records and extracted data independently. Risk of bias and certainty of evidence were appraised descriptively, and no meta-analysis was performed because of heterogeneity in assays, designs and outcomes.
Results
Fifty-four unique records were screened; 29 reports (21 clinical/longitudinal and 8 analytical/diagnostic) were summarized. DYNAMIC reduced chemotherapy use in stage II colon cancer from 28% to 15% with similar five-year recurrence-free survival (88% vs 87%). IMvigor011 improved disease-free survival (hazard ratio 0.64) and overall survival (hazard ratio 0.59) in ctDNA-positive muscle-invasive bladder cancer. DETECT-A and PATHFINDER supported screening-pathway feasibility; SYMPLIFY and THUNDER supplied separate diagnostic context. Mortality benefit was not tested.
Conclusions
ctDNA has clinical utility in selected molecular-residual-disease settings when a prespecified result triggers effective treatment. In most settings it remains prognostic. MCED requires randomized net-benefit, mortality, and harm evaluations before population implementation.
Keywords
Article history
- Received
- Revised
- Accepted
- First published online
Peer-review model: Double-blind external peer review · Version: Version of Record
Supplementary materials
Supplementary tables and materials are included within the Version of Record PDF and HTML full text where present.