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ASCO 2025 | The use of ctDNA in prostate cancer diagnosis and treatment

Stefanie Zschaebitz, MD, Heidelberg University Hospital, Heidelberg, Germany, highlights the potential of circulating tumor cells (CTCs) and cell-free DNA (cfDNA) as novel biomarkers in prostate cancer, citing a promising 84% concordance rate in her clinic, which is a significant improvement over traditional tumor tissue analysis. However, she notes that challenges remain, including distinguishing between tumor-derived and non-tumor-derived cfDNA. This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

What is the case for ctDNA? We have been looking not only in tumor tissue and actual alterations within the tumor tissue, but also in ctDNA. In most cases, at least in our clinic, and I think in most clinics in Germany, probably also in other countries, tumor tissue is mostly used and not so much ctDNA. But we had like an 84% concordance, which is pretty promising, I would say because it’s so much easier to just draw blood...

What is the case for ctDNA? We have been looking not only in tumor tissue and actual alterations within the tumor tissue, but also in ctDNA. In most cases, at least in our clinic, and I think in most clinics in Germany, probably also in other countries, tumor tissue is mostly used and not so much ctDNA. But we had like an 84% concordance, which is pretty promising, I would say because it’s so much easier to just draw blood. There was another talk in the same session and that indicated that there’s also CHIP-like clonal hematopoiesis which gets more common in elderly populations so we might also find some HRR mutations that come from CHIP. So I think there are some challenges with ctDNA as well because we have to figure out if that’s from the tumor or if that’s not from the tumor.

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