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ASCO 2026 | ctDNA monitoring for recurrence in bone and soft tissue sarcoma

Maggie Zhou, MD, Stanford University School of Medicine, Stanford, CA, discusses a retrospective analysis evaluating circulating tumor DNA (ctDNA) monitoring after curative-intent resection for bone and soft tissue sarcoma. Using a personalized assay, the study demonstrated high specificity and moderate sensitivity for relapse detection. Performance varied by histologic subtype, with lower sensitivity for lung-only recurrence. Notably, ctDNA often preceded radiographic detection, suggesting utility for surveillance. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

So as a brief overview, soft tissue sarcomas and bone sarcomas are overall very rare cancers. There are over 100 different subtypes and overall they account for less than 1% of all adult malignancies. There’s a great need for new technology for MRD detection and treatment response monitoring for this really high unmet need population. And so we were interested in incorporating ctDNA monitoring as a method for MRD detection...

So as a brief overview, soft tissue sarcomas and bone sarcomas are overall very rare cancers. There are over 100 different subtypes and overall they account for less than 1% of all adult malignancies. There’s a great need for new technology for MRD detection and treatment response monitoring for this really high unmet need population. And so we were interested in incorporating ctDNA monitoring as a method for MRD detection. We found that there is a very high positive predictive value for ctDNA positivity. However, there are some considerations for sensitivity, for instance, for lung metastasis-only recurrence. But I think this is a really evolving area of research and really promising for transforming the care for our patients.

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