A Position Paper on ctDNA Testing in Clinical Trials

In this episode of JCO Precision Oncology Conversations, Dr. Rafeh Naqash interviews Dr. Philip Philip about circulating tumor DNA (ctDNA) testing in clinical trials, focusing on a position paper by the National Cancer Institute GI Oncology Circulating Tumor DNA Working Group. The discussion covers the rationale behind the perspective piece, the differences between tumor-informed and non-tumor-based ctDNA assessments, and the consensus recommendation to use ctDNA-based metrics as a co-primary endpoint in early-phase trials. They also discuss the challenges of false negatives, the psychological impact of ctDNA testing on patients, and the need for more data before treating solely based on positive ctDNA results, with Dr. Philip sharing insights from his career and offering advice to trainees and early career investigators.