Is there any role for ctDNA testing after surgery or SBRT for Stage IB NSCLC to determine the need for adjuvant chemotherapy?

This is another emerging use for ctDNA that has shown promising results in small studies. The TRACERx consortium in the UK looked at the evolution of early NSCLC over time in 100 patients who underwent resection. They performed multi-region sampling and whole-exome sequencing and created patient-specific multiplex PCR assays to track each patient’s ctDNA over time after surgery. They were able to reconstruct phylogenetic trees demonstrating clonal and sub-clonal mutations in each patient. In a s...