Observational studyClinical cancer research : an official journal of the American Association for Cancer Research2025
Early Postoperative Minimal Residual Disease Detection with MAESTRO Is Associated with Recurrence and Worse Survival in Patients with Head and Neck Cancer.
Observational study in Clinical cancer research : an official journal of the American Association for Cancer Research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed.
- Guided immunotherapy for residual solid tumor: integrating platelets and CAR T cells to reduce post-surgical recurrence.Biomarker research · 2026Review
- Liquid Biopsies in HNSCC: Current Landscape and Emerging Opportunities in the Era of HPV Stratification.International journal of molecular sciences · 2026Review
- Personalized ctDNA analysis for detection of residual disease and recurrence in surgically treated HNSCC patients.NPJ precision oncology · 2026Article
- Prognostic value of tumor-informed ctDNA in HPV-independent head and neck squamous cell carcinoma.medRxiv : the preprint server for health sciences · 2026Article
- Circulating tumour cells and circulating tumour DNA in head and neck cancer: from molecular insights to clinical impact.Cancer metastasis reviews · 2025Review
- Whole-exome ctDNA sequencing reveals intratumoral heterogeneity and drivers of relapse in locally advanced head and neck cancer.ESMO open · 2025Article
- From residual risk to precision intervention: the evolving role of minimal residual disease in breast cancer management.Cancer biology & medicine · 2025Review
- Clinical validation of an HPV whole genome sequencing assay for molecular residual disease detection in HPV-associated head and neck cancer patients treated with surgery.medRxiv : the preprint server for health sciences · 2025Article
- Liquid Biopsies in Head and Neck Cancers: Recent Developments Across Biofluids, Analytes, and Molecular Features.Head & neck · 2025Review
- Targeted Screening Strategies for Head and Neck Cancer: A Global Review of Evidence, Technologies, and Cost-Effectiveness.Diagnostics (Basel, Switzerland) · 2025Review
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Abstract
purposeAlthough ctDNA is a promising biomarker for minimal residual disease (MRD) detection in head and neck squamous cell carcinoma (HNSCC), more sensitive assays are needed for accurate MRD detection at clinically relevant time points. Ultrasensitive MRD detection early after surgery could guide adjuvant therapy decisions, but early ctDNA dynamics are poorly understood. EXPERIMENTAL
designWe applied minor allele-enriched sequencing through recognition oligonucleotides (MAESTRO), a whole-genome, tumor-informed, mutation enrichment sequencing assay, in a pooled testing format called MAESTRO-Pool, to plasma samples from patients with HNSCC collected shortly after surgery and during surveillance. We evaluated whether early MRD detection could predict outcomes.
resultsAmong 24 patients with predominantly human papillomavirus-independent (95.8%) HNSCC, rapid ctDNA clearance occurred by the first postoperative sample (1-3 days postoperatively) in nine patients without an event (recurrence or death). Thirteen of fifteen patients with an event were MRD-positive (positive predictive value = 92.9%; negative predictive value = 80%) with a median tumor fraction (TFx) of 54 parts per million (ppm; range 6-1,177 ppm). In the first and last samples of the early postoperative window, 8/13 and 10/13 patients, respectively, had TFx below 100 ppm, the detection limit of leading commercial assays. Early MRD detection correlated with worse overall survival (HR, 8.3; 95% confidence interval, 1.1-66.1; P = 0.02) and event-free survival (HR, 27.4; 95% confidence interval, 3.5-214.5; P < 0.0001) independent of high-risk pathology.
conclusionsEarly postoperative MRD detection by MAESTRO was associated with recurrence and worse survival. Given the ultralow TFxs observed, ultrasensitive assays will be essential for reliable MRD detection during early postoperative time points to enable personalized adjuvant therapy decision-making in HNSCC. See related article by Bryan et al., p. 3483.
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