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However, studies involving long-term blood sampling are required to comprehensively interpret the clinical use of ctDNA analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective multicenter cohort study (LUNGCA) for dynamic ctDNA monitoring in lung cancer patients receiving curative-intent surgery. ctDNA analysis was conducted on preoperative plasma samples, at postoperative 3 days and 1 month, and then every 3-6 months for up to 3 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 233 non-small cell lung cancer (NSCLC) patients and 2336 longitudinal plasma samples were included; the median follow-up was 51.4\u2009months. Post-comprehensive treatment (after radical surgery + necessary adjuvant therapy) MRD status was better at predicting relapse than postoperative MRD status (positive predictive value: 100% vs 90.0%; negative predictive value: 90.3% vs 90.1%). Patients with positive pre-adjuvant ctDNA and targetable mutations in tumor tissues had improved recurrence-free survival (RFS) with corresponding adjuvant tyrosine kinase inhibitor (TKI) treatment (hazard ratio [HR] = 0.01, P = .005), but adjuvant chemotherapy failed to improve RFS (HR\u2009=\u20090.6, P = .491). Of patients receiving adjuvant therapies, patients with a negative- or positive-negative ctDNA change pattern had favorable and similar RFS (P = .419), whereas patients with a positive- or negative-positive pattern had worse RFS (P &amp;lt; .001). TKI therapy was more effective than chemotherapy in clearing ctDNA. Post-relapse ctDNA negativity was associated with favorable OS (HR\u2009=\u20090.4; P = .029).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Comprehensive interpretation of dynamic ctDNA monitoring data can inform precise whole-course postsurgical management of NSCLC patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djaf061","type":"journal-article","created":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T08:45:47Z","timestamp":1742719547000},"page":"1474-1484","source":"Crossref","is-referenced-by-count":16,"title":["Dynamic ctDNA informs whole-course postoperative precise management of NSCLC (LUNGCA study)"],"prefix":"10.1093","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7126-8037","authenticated-orcid":false,"given":"Liang","family":"Xia","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University , Chengdu,","place":["China"]},{"name":"Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, West China Hospital, Sichuan University , Chengdu,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7221-0259","authenticated-orcid":false,"given":"Qiang","family":"Pu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University , Chengdu,","place":["China"]},{"name":"Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, West China Hospital, Sichuan University , Chengdu,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2028-8043","authenticated-orcid":false,"given":"Ran","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University , Chengdu,","place":["China"]},{"name":"Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, West China Hospital, Sichuan University , Chengdu,","place":["China"]},{"name":"State Key Laboratory of Biotherapy, West China Hospital, Sichuan University , Chengdu,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0842-5540","authenticated-orcid":false,"given":"Jiandong","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan 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