ArticleFrontiers in oncology2026
Neoadjuvant ctDNA-MRD monitoring uncovers occult progression despite radiologic response in locally advanced hypopharyngeal carcinoma: a case report.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The assessment of treatment response during neoadjuvant therapy for head and neck squamous cell carcinoma (HNSCC) relies largely on radiographic and endoscopic evaluations, which may fail to detect minimal residual disease (MRD). Circulating tumor DNA (ctDNA)-based MRD monitoring has emerged as a sensitive biomarker capable of revealing molecular disease activity that is not captured by imaging. Evidence supporting its use in the neoadjuvant setting of HNSCC remains limited. Case presentation: We report a 53-year-old man with locally advanced hypopharyngeal squamous cell carcinoma (cT4N2cM0) who received three cycles of neoadjuvant immunochemotherapy (toripalimab, cisplatin, and nab-paclitaxel). Radiologic and endoscopic assessment demonstrated a partial response with a 71.6% reduction in tumor burden and near-complete mucosal normalization. In contrast, ctDNA-MRD analysis showed elevated ctDNA levels compared with baseline, indicating molecular progression. Despite the favorable imaging response, the patient developed new distant metastases three months after definitive chemoradiotherapy and maintenance immunotherapy, confirming systemic disease progression. Discussion: This case highlights the limitations of imaging in differentiating true tumor regression from residual disease during neoadjuvant therapy. Persistent ctDNA-MRD despite radiologic remission may signal occult progression and could influence critical treatment decisions, including the choice between surgery, chemoradiation, or systemic intensification. Accumulating evidence from other tumor types suggests that MRD clearance may predict pathological complete response (pCR), raising the possibility that accurate molecular assessment could help identify patients who may safely avoid surgery. However, MRD applications in neoadjuvant HNSCC-particularly hypopharyngeal carcinoma-remain sparsely studied. Conclusion: ctDNA-MRD may provide complementary and potentially earlier insights into treatment response compared with imaging alone. Its incorporation into neoadjuvant strategies for HNSCC warrants further investigation and may ultimately support more personalized and accurate therapeutic decision-making.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.