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ASCO 2025 | What are the barriers to ctDNA monitoring in endometrial cancer?

Shannon Westin, MD, FASCO, The University of Texas MD Anderson Cancer Center, and GOG-F, Houston, TX, discusses the current limitations facing the integration of circulating tumor DNA (ctDNA) monitoring in clinical practice across cancer types. Although ctDNA assays are becoming more accessible there is limited research data, particularly for endometrial cancer, which, despite being the most common gynecological malignancy, has been underrepresented in ctDNA research. This interview took place at the 2025 American Society of Clinical Oncology (ASCO) meeting in Chicago, IL.

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Transcript

Well, I mean, I think the main limitation is what we’re seeing across all cancers is what do we do with the results, right? So if I identify somebody that’s ctDNA positive, does it help to start treatment early, maybe before I can see anything on a scan? I think that’s an unanswered question in endometrial cancer especially. So I think that’s one limitation...

Well, I mean, I think the main limitation is what we’re seeing across all cancers is what do we do with the results, right? So if I identify somebody that’s ctDNA positive, does it help to start treatment early, maybe before I can see anything on a scan? I think that’s an unanswered question in endometrial cancer especially. So I think that’s one limitation. And then I think, you know, it’s unfortunately, you know, endometrial cancer is the most common gynecologic malignancy, but it’s often a later area of study. So we just don’t have as much data in endometrial cancer as we do in some of the other solid tumors. And there are ctDNA assays that are already clinically available. And I see people in my practice that have gotten those tested, you know, on the outside, but I’m not always sure what to do with it yet. So I think more and more studies like this one that come out with information saying, okay, it can affect prognosis and potentially it can improve treatment, then that gives us something we can do with it. Okay, you have positive ctDNA. Let’s add another drug to your regimen to try to help clear that.

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