{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:08:15Z","timestamp":1791943695224,"version":"4.3.4"},"reference-count":40,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Lung cancer remains the leading cause of cancer-related mortality worldwide, with a substantial risk of recurrence even in early-stage non\u2013small cell lung cancer (NSCLC) after curative surgery. Circulating tumor DNA (ctDNA)\u2013based detection of minimal residual disease (MRD) has emerged as a promising tool for identifying patients at increased risk of relapse. However, the predictive effectiveness of ctDNA remains uncertain because of variability in study designs, detection strategies, and statistical power.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS<\/jats:title>\n                    <jats:p>We conducted a systematic meta-analysis of 30 studies involving 3,287 patients with postoperative NSCLC to evaluate the diagnostic performance of ctDNA-based MRD testing for recurrence detection and survival prediction. Eligible studies were identified through a comprehensive literature search and quality-assessed using the QUADAS-2 tool. Pooled diagnostic estimates were calculated using bivariate random-effects models. Subgroup analyses compared tumor-informed and tumor-agnostic detection strategies at both landmark and longitudinal postoperative time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      In landmark analyses, tumor-informed assays demonstrated higher specificity (0.97\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      0.93) and AUC (0.81\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      0.70) than tumor-agnostic approaches, which showed slightly higher sensitivity (0.44\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      0.42). In longitudinal monitoring, the differences narrowed: tumor-informed assays retained higher specificity (0.96\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      0.88), whereas tumor-agnostic methods exhibited modestly higher sensitivity (0.79\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      0.76) and AUC (0.91\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      0.86).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Our findings indicate that ctDNA-based MRD testing provides clinically meaningful prognostic information for postoperative recurrence in early-stage NSCLC. Both detection strategies offer complementary strengths, with tumor-informed assays excelling in specificity and tumor-agnostic approaches offering greater sensitivity in some settings. These results highlight the potential of ctDNA MRD testing to enhance postoperative surveillance and guide personalized disease management in early-stage NSCLC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/po-25-00489","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T19:59:10Z","timestamp":1760039950000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":12,"title":["Predictive Effectiveness of Circulating Tumor DNA in Recurrent Early-Stage Non\u2013Small Cell Lung Cancer: An Updated Meta-Analysis"],"prefix":"10.1200","author":[{"given":"Di","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nengke","family":"Lin","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine, Southern Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaobin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4159-0099","authenticated-orcid":true,"given":"Qifan","family":"Jing","sequence":"additional","affiliation":[{"name":"Nanjing Geneseeq Technology Inc, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9523-1930","authenticated-orcid":true,"given":"Jiani C.","family":"Yin","sequence":"additional","affiliation":[{"name":"Nanjing Geneseeq Technology Inc, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Shi","sequence":"additional","affiliation":[{"name":"Nanjing Geneseeq Technology Inc, Nanjing, 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