Circulating Tumor DNA Could Improve Minimal Residual Disease Detection for Ovarian Cancer

Key Takeaways:

• Circulating tumor DNA (ctDNA) could be a more accessible method of minimal residual disease (MRD) detection in patients with ovarian cancer as it does not require surgery, unlike second look laparoscopy (SLL).
• Both ctDNA and SLL had high rates of consistency, with 73.6% achieving concordant results with both tests.
• In discordant cases, ctDNA demonstrated more accuracy in predicting progression free survival (PFS) than SLL.

Detecting MRD in patients with ovarian cancer helps predict survival outcomes and the risk of recurrence. Traditionally, MRD was observed using SLL, but the need for surgery limits its accessibility, so ctDNA was developed as a non-invasive alternative.

In an abstract presented at the 2026 American Society of Clinical Oncology (ASCO) meeting, researchers compared the efficacy of SLL and ctDNA in detecting MRD. The study assessed patients with high-grade epithelial ovarian cancer who completed frontline chemotherapy. 

SLL vs ctDNA

A total of 72 patients were included in the study, and 69 (95.8%) were declared to be in remission. However, MRD was still detected in 30 patients (41.7%) using ctDNA and in 33 patients (45.8%) using SLL.

The MRD results were consistent for a majority (73.6%) of patients. Eight patients had a positive ctDNA result but a negative SLL result. Since the publication of the abstract, 75% of these patients have recurred. These patients also had worse PFS than patients whose ctDNA and SLL results were both negative.

Eleven patients had a positive SLL result but a negative ctDNA result. Since the publication of the abstract, 54.5% of these patients have recurred. These patients had no significant difference in PFS than patients whose ctDNA and SLL results were both negative.

Implications for Oncology Care

The findings showed the ability of ctDNA to accurately detect MRD in patients with high-grade ovarian cancer and predict PFS.

The study’s authors said, “Although discordance occurs between ctDNA and SLL, these data suggest that ctDNA may detect clinically meaningful MRD not captured by SLL and could represent a more clinically relevant prognostic tool in this setting.”

Reference

Clark HD, Lee S, Knisely A, et al. Circulating tumor DNA to enhance detection of high-risk minimal residual disease in ovarian cancer relative to second look laparoscopy. ASCO Annual Meeting. J Clin Oncol. 2026;44(16):5567. doi:10.1200/JCO.2026.44.16_suppl.5567