{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:31:05Z","timestamp":1786123865826,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100013815","name":"Kr\u00e6ftfonden","doi-asserted-by":"publisher","award":["10272-0007"],"award-info":[{"award-number":["10272-0007"]}],"id":[{"id":"10.13039\/501100013815","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100024075","name":"Region Syddanmark","doi-asserted-by":"publisher","award":["23\/7836"],"award-info":[{"award-number":["23\/7836"]}],"id":[{"id":"10.13039\/501100024075","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005940","name":"dansk kr\u00e6ftforsknings fond","doi-asserted-by":"publisher","award":["PLSNR-ACTIVE.FID2444075"],"award-info":[{"award-number":["PLSNR-ACTIVE.FID2444075"]}],"id":[{"id":"10.13039\/501100005940","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research Council of Lillebaelt Hospital","award":["2024-0031"],"award-info":[{"award-number":["2024-0031"]}]},{"name":"The Torn\u00f8e and H\u00f8yrup Foundation","award":["32120251"],"award-info":[{"award-number":["32120251"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Med Oncol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lung cancer is a heterogeneous disease with unpredictable trajectories. Risk stratification in lung cancer remains imprecise within tumor-node-metastasis (TNM) stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This work aims to evaluate whether methylated circulating tumor DNA (ctDNA) can improve prognostication at the time of diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We enrolled 213 participants with recently diagnosed lung cancer, of whom 100 underwent curative treatment and 113 underwent palliative treatment. All blood samples were collected prior to lung cancer diagnosis and analyzed using multiplex methylation-specific digital droplet polymerase chain reaction targeting five methylated ctDNA markers. ctDNA output was interpreted in two models: a three-tiered (negative\/Low-level\/High-level ctDNA) and a binary (negative\/positive).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We observed significantly increased overall survival (OS) among all participants with negative or low-level ctDNA results compared with those with high-level ctDNA. The adjusted hazard ratio (HR) for OS was higher when comparing high-level ctDNA to negative results (HR\u2009=\u20091.96, 95% confidence interval (CI): 1.09\u20133.51;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.024). In the palliative treatment subgroup, HR for progression-free survival was higher comparing high-level ctDNA to negative results (adjusted HR\u2009=\u20092.32, 95% CI: 1.10\u20134.92;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.028). In the curative treatment subgroup, the association between ctDNA levels and recurrence-free survival was not statistically significant (adjusted HR\u2009=\u20091.81, 95% CI: 0.73\u20134.48;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.200).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Detection of, and risk stratification based on, levels of methylated ctDNA at diagnosis appears to provide valuable prognostic information in lung cancer, both in early and late stages of the disease. Such information may have implications for the choice of follow-up regimens and treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective observational cohort study using prospectively collected blood samples.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17588359261469547","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:15:44Z","timestamp":1785899744000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic performance of a novel multiplex circulating tumor DNA assay for lung cancer outcomes"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0434-8285","authenticated-orcid":false,"given":"Peter","family":"Hjorth-Hansen","sequence":"first","affiliation":[{"name":"Department of Oncology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0101-328X","authenticated-orcid":false,"given":"Line","family":"Nederby","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Immunology, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, Vejle DK-7100, Denmark"},{"name":"Department of Oncology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilie Mondrup","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, Odense, Denmark"},{"name":"Department of Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark"},{"name":"Department of Internal Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Borg","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research, University of Southern Denmark, Odense, Denmark"},{"name":"Department of Internal Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole","family":"Hilberg","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research, University of Southern Denmark, Odense, Denmark"},{"name":"Department of Internal Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Witting Christensen","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research, University of Southern Denmark, Odense, Denmark"},{"name":"Department of Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Signe","family":"Timm","sequence":"additional","affiliation":[{"name":"Department of Oncology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torben Fr\u00f8strup","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Lillebaelt Hospital, University Hospital of Southern 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