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ESMO Asia 2025 | ctDNA MRD guides adjuvant therapy in resected hepatocellular carcinoma
Stephen Lam Chan, MD, FRCP, Chinese University of Hong Kong, Hong Kong, China, explores whole-exome sequencing-based circulating tumor DNA (ctDNA) to detect minimal residual disease (MRD) in patients with resected hepatocellular carcinoma. MRD positivity at 1 month post-surgery predicts shorter recurrence-free and overall survival. Patients who were MRD-positive benefited from adjuvant therapy, particularly systemic treatment, while MRD-negative patients did not. These results support ctDNA-guided MRD assessment to personalize adjuvant therapy and improve patient outcomes. This interview took place at 2025 European Society for Medical Oncology (ESMO) Asia Congress in Singapore, Singapore.
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Transcript
There have been a late-breaking abstract on the patients with HCC. And for those patients after surgery, there have been a WES-powered MRD to detect the circulating tumor DNA in the plasma. So what key result from this study is that, first, the detection of the ctDNA, which is MRD, was associated with the worst outcome in terms of recurrence-free survival as compared to those patients without the detectable circulating tumor DNA...
There have been a late-breaking abstract on the patients with HCC. And for those patients after surgery, there have been a WES-powered MRD to detect the circulating tumor DNA in the plasma. So what key result from this study is that, first, the detection of the ctDNA, which is MRD, was associated with the worst outcome in terms of recurrence-free survival as compared to those patients without the detectable circulating tumor DNA. And they also showed that for those with a ctDNA-negative group, the adjuvant therapy for HCC after surgery did not improve the survival benefit. So there’s a room for the escalation of the adjuvant therapy in this good prognostic ctDNA-negative group. On the other hand, for those ctDNA-positive group, the use of the adjuvant therapy was associated with a better recurrence-free survival as compared to the surveillance group. So meaning that there’s a room for escalation of the therapy in the ctDNA-positive group. So I think that this is a potentially important study because the use of the personalized treatment or MRD, while it has been studied in other cancer types like colon cancer or lung cancer, it has not been formally studied in liver cancer. So this study highlights the potential of developing an RCT-comparative adjuvant versus no adjuvant in the ctDNA-positive subgroup. And I think a multi-center study is required for future development.
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