Blog

Daniel Sumarriva: Highlights from ASCO25 on MRD and ctDNA

Daniel Sumarriva/LinkedIn

Jun 8, 2025, 04:26

Daniel Sumarriva: Highlights from ASCO25 on MRD and ctDNA

Daniel Sumarriva, Executive Medical Director at SAGA Diagnostics, posted on LinkedIn:

“Highlights from ASCO25 on MRD and ctDNA
The question patients often ask, “Doc, how do I know if my cancer is back?” and the anxiety around scans begs for a better surrogate to monitor recurrence. At ASCO 2025, several pivotal studies emphasized the transformative impact of ctDNA and MRD testing for earlier, more precise recurrence detection.

Breast Cancer Highlights:

SERENA6 Trial: Demonstrated significant improvement in progression-free survival (16 months vs. 9 months, HR 0.44) through ctDNA-based monitoring of ESR1 mutations, supporting tailored therapy decisions.
DARE Study: Early ctDNA clearance significantly correlated with improved outcomes, reinforcing ctDNA dynamics as a powerful prognostic tool.
TBCRC040 (PREDICT-DNA): Confirmed ctDNA clearance pre-cycle 2 therapy as predictive of recurrence risk, underscoring its clinical utility for early therapeutic interventions (p<0.05).
SWOGS1416 and TTNT Analysis: Established that early ctDNA dynamics within 6 weeks notably influenced treatment decisions, guiding tailored therapeutic strategies.
ISPY2 Trial: Provided evidence that ctDNA reliably predicts residual nodal burden post-neoadjuvant chemotherapy, significantly influencing surgical decisions to reduce morbidity.

Colorectal Cancer Insights:

AGITGDYNAMICIII Trial: Validated clinical and economic benefits of ctDNA-guided chemotherapy escalation in stage III colorectal cancer.
Pan-Cancer Progress:
MONSTARSCREEN3 Study: Set new benchmarks with ultra-sensitive pan-cancer MRD detection via whole-genome sequencing (WGS), detecting low ctDNA levels below 100 ppm with strong specificity.
Clinical Utility and Sensitivity Considerations:
Growing consensus for tumorInformed assays with higher sensitivity, specially with shorter turnaround times, reflecting clinician preference for reliable, clinically actionable results.
UltraSensitive assays (below 1 ppm) introduced, such as SAGA Diagnostics PathlightMRD, demonstrated significant LeadTime in detecting breast cancer recurrence, crucial for clinicalmanagement and therapydecisions.
As Dr. Alexandra Thomas eloquently stated, we now have strong “proof of concept” supporting ctDNA-guided therapy. To fully realize MRD’s potential, the NextGeneration of clinicalTrials must be prioritized. Early ctDNA dynamics offer critical prognostic insights across cancer stages, raising the essential question: “MRD is here and brings shifting paradigms—the question is to C (see) or not to ctDNA?”
Grateful to see in a plenary session PathlightMRD listed as one of the main and most sensitive MRD assays, as well as our TRACERstudy data with Princess Margaret Cancer Centre showing how persistent detection of ctDNA is strongly associated with disease recurrence”