Evidence map›Paper›PMID 39998904›Full record

SynthesisThe oncologist2025

Plasma ctDNA kinetics as a predictor of systemic therapy response for advanced non-small cell lung cancer: a systematic review and meta-analysis.

Luís F Leite da Silva, Erick F Saldanha, Júnior Samuel Alonso de Menezes, Leonardo Halamy Pereira, João Alexandre R de Bragança Dos Santos, Isabella Romagnoli Buonopane, Erito M de Souza, Caio Ulysses Galvani de Menezes, Gilberto Lopes

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The oncologist, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Luís F Leite da SilvaDepartmento de Ciências Médicas, Universidade Federal Fluminense, Niterói, RJ 24033-900, Brazil.
Erick F SaldanhaDepartment of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, ON M5G 2M9, Canada.
Júnior Samuel Alonso de MenezesDepartamento de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA 21941-590, Brazil.
Leonardo Halamy PereiraDepartmento de Ciências Médicas, Universidade Federal Fluminense, Niterói, RJ 24033-900, Brazil.
João Alexandre R de Bragança Dos SantosDepartmento de Ciências Médicas, Universidade Federal Fluminense, Niterói, RJ 24033-900, Brazil.
Isabella Romagnoli BuonopaneDepartamento de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA 21941-590, Brazil.
Erito M de SouzaDepartmento de Ciências Médicas, Universidade Federal Fluminense, Niterói, RJ 24033-900, Brazil.
Caio Ulysses Galvani de MenezesDepartamento de Oncologia Clínica, Universidade Federal de São Paulo, SP 04023-062, Brazil.
Gilberto LopesSylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPredicting early treatment response in advanced non-small cell lung cancer (NSCLC) is challenging. Longitudinal monitoring of circulating tumor DNA (ctDNA) can track tumor response to treatments like immune checkpoint blockade (ICB) and correlate with outcomes. This meta-analysis evaluated whether ctDNA clearance or decrease is associated with improved survival across various settings in NSCLC.

methodsA systematic review of MEDLINE, EMBASE, and Cochrane databases (up to April 2024) identified studies evaluating the impact of ctDNA kinetics on survival outcomes in non-curative NSCLC settings. Pooled hazard ratios (HR) for progression-free survival (PFS) and overall survival (OS) were calculated using a random effects model.

resultsWe included 32 studies with 3047 NSCLC patients receiving systemic therapies such as targeted therapy (TT), ICB, and chemotherapy. Meta-analysis of 31 studies showed that ctDNA decrease/clearance was linked to improved PFS (HR: 0.32 [0.26, 0.40], I² = 63%, P < .01). Subgroup analysis indicated strong PFS benefits from ctDNA clearance (HR: 0.27 [0.20, 0.36]). Similar improvements were seen across patients undergoing targeted therapy (HR: 0.34) and ICB (HR: 0.33). Analysis of 25 studies revealed a significant association between ctDNA reduction and better OS (HR: 0.31 [0.23, 0.42], I² = 47%, P < .01). Subgroup findings were consistent for both TT (HR: 0.41) and ICB (HR: 0.32). Sensitivity analysis demonstrated that ctDNA clearance/decrease was consistently associated with improved PFS across study designs and ctDNA analysis methods. There was no significant variation in hazard ratios for PFS based on NSCLC subtypes, smoking status, or sex.

conclusionPlasma ctDNA kinetics was associated with improved survival outcomes in patients diagnosed with advanced NSCLC undergoing treatment with TT and ICB.

Indexed as

Biomarkers, TumorCarcinoma, Non-Small-Cell LungCirculating Tumor DNALung NeoplasmsHumansPrognosisBiomarkers, TumorCirculating Tumor DNActDNAmolecular responseNSCLCprecision oncology

Identifiers

PMID39998904
PMCPMC11853598

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.