ArticleNature medicine2025
Cerebrospinal fluid circulating tumor DNA profiling for risk stratification and matched treatment of central nervous system metastases.
Article in Nature medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cerebrospinal fluid ctDNA as a prognostic and disease-activity biomarker in leptomeningeal metastases: systematic review, meta-analysis, and implications for CSF-guided care.Journal of neuro-oncology · 2026Pooled it
- Cerebrospinal fluid ctDNA as a diagnostic and prognostic tool in gliomas: a systematic review and meta-analysis.Frontiers in oncology · 2025Pooled it
- Cerebrospinal fluid circulating tumor DNA profiling in central nervous system metastases from solid tumors: A prospective multicentre translational analysis of the BrainStorm (OncoDistinct-006) study.The journal of liquid biopsy · 2026Article
- Characterizing intradural spinal metastasis in the metastatic cascade: clinical course, dissemination timing, and molecular features in 69 patients.Journal of neuro-oncology · 2026Article
- Targeting ClassicalCancers · 2026Review
- Low-input CSF cfDNA shallow whole-genome sequencing for CNV-based diagnosis and monitoring of leptomeningeal metastasis in lung cancer.Acta neuropathologica communications · 2026Article
- Downregulated lysyl oxidase in plasma extracellular vesicles: a biomarker linked to brain metastasis risk in lung adenocarcinoma.BMC medicine · 2026Article
- Intracranial metastases from solid tumors: Call to action and consensus from the Society for Neuro-Oncology and American Society of Clinical Oncology collaborative.Neuro-oncology · 2026Review
- [Chinese Expert Consensus on Clinical Management of Oncogene Addicted Non-small Cell Lung Cancer with Leptomeningeal Metastasis (2026 Edition)].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2026Article
- Savolitinib in brain and leptomeningeal metastases from non-small cell lung cancer: a case report.Frontiers in oncology · 2026Article
- Liquid biopsy biomarkers for cancer detection, treatment monitoring, and clinical outcome prediction.Frontiers in cell and developmental biology · 2026Review
- Integrative Analysis of Clinical Features and Cerebrospinal Fluid Immune Microenvironment in Leptomeningeal Metastasis From Non-small-cell Lung Cancer Patients.Clinical Medicine Insights. Oncology · 2026Article
- The evolving landscape of leptomeningeal metastases from NSCLC: an international, contemporary, multicenter cohort study.Annals of oncology : official journal of the European Society for Medical Oncology · 2026Article
- Review
- Clinical Features, Molecular Biology, and the Metastatic Microenvironment in Lung Cancer Brain Metastases: Implications for Treatment Decisions.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Review
- Chinese Expert Consensus on Leptomeningeal Metastases of Lung Cancer.Thoracic cancer · 2025Article
- Editorial: Treatment of brain metastases from non-small cell lung cancer: preclinical, clinical, and translational research.Frontiers in oncology · 2025Article
Corrections and comments
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Authors and funding
30 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Genomic profiling of central nervous system (CNS) metastases has the potential to guide treatments. In the present study, we included 584 patients with non-small-cell lung cancer and CNS metastases and performed a comprehensive analysis of cerebrospinal fluid (CSF) circulating tumor DNA (ctDNA) with clinicopathological annotation. CSF ctDNA-positive detection was independently associated with shorter survival than negative detection (hazard ratio (HR) = 1.9, 95% confidence interval (CI) = 1.56-2.39; P < 0.0001). Matched tumor-CSF analysis characterized the CSF private molecular features causing poor survival (HR = 1.64, 95% CI = 1.15-2.32, P = 0.006). A multimetric CSF ctDNA prognostic model integrating CSF ctDNA features and clinical factors was developed for risk-stratifying CNS metastases and validated in an independent cohort. Among patients with treatment histories available, those positive for a driver alteration by CSF ctDNA showed a survival benefit from CSF-matched therapy (HR = 0.78, 95% CI = 0.65-0.92, P = 0.003). Longitudinal monitoring by CSF identified CNS-specific resistant mechanisms and a second matched targeted therapy indicating improved survival (HR = 0.56, 95% CI = 0.35-0.91, P = 0.018). These findings support the clinical value of CSF ctDNA for risk-stratifying CNS metastases and guiding therapy.
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