Circulating Tumor DNA Dynamics as an Early Predictor of Recurrence in Operable Non-Small Cell Lung Cancer

International Journal of Medical Advances and Discoveries | Vol. 17, No. 8, August 2026 | pp. 102–108

DOI: 10.46882/2026/IJMAD/1708102

Short Communication

Title: Circulating Tumor DNA Dynamics as an Early Predictor of Recurrence in Operable Non-Small Cell Lung Cancer

Names of Authors: Sarah L. Choi¹, David K. Miller²

Authors’ Affiliations: ¹Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, USA; ²Department of Thoracic Surgery, Stanford University Medical Center, Stanford, USA

Abstract: Detecting minimal residual disease (MRD) following surgical resection of non-small cell lung cancer (NSCLC) is vital to identifying patients at high risk of relapse. This prospective longitudinal study explored the utility of personalized, tumor-informed circulating tumor DNA (ctDNA) assays in tracking post-operative MRD dynamics. Plasma samples were collected from 75 patients with resectable Stage I-IIIA NSCLC at baseline, post-operative day 3, and every 3 months for up to 24 months. Ultra-deep next-generation sequencing was used to trace patient-specific somatic variants. Detectable ctDNA on post-operative day 3 was identified in 16.0% (12/75) of patients, strongly correlating with a shorter disease-free survival (DFS) profile (Hazard Ratio [HR] = 5.4, 95% CI: 2.8–10.6, p < 0.001). Longitudinal tracking revealed that 18 patients developed a positive ctDNA status during follow-up; of these, 16 experienced clinical recurrence confirmed via radiological imaging. The median lead time between molecular ctDNA detection and radiological recurrence confirmation was 5.2 months (range: 2.1–9.4 months). For patients who maintained a longitudinal ctDNA-negative profile, the 2-year DFS rate was 91.2%, compared to 11.1% for those with persistent or emergent ctDNA positivity (p < 0.001). Tracking post-operative ctDNA dynamics provides an effective, highly sensitive window for early recurrence detection in operable NSCLC, offering a solid molecular platform for early adjuvant therapeutic intervention.

Keywords: Non-small cell lung cancer, Circulating tumor DNA, Minimal residual disease, Liquid biopsy, Post-operative recurrence, Disease-free survival

Manuscript Timeline: Received: June 01, 2026; Revised: July 04, 2026; Accepted: July 22, 2026; Published: August 14, 2026

Citation: Choi, S. L., & Miller, D. K. (2026). Circulating Tumor DNA Dynamics as an Early Predictor of Recurrence in Operable Non-Small Cell Lung Cancer. International Journal of Medical Advances and Discoveries, 17(8), 102–108. doi:10.46882/2026/IJMAD/1708102

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