European journal of cancer (Oxford, England : 1990)
September 11, 2026 · via Europe PMC
Longitudinal analysis of circulating tumor DNA and CA19-9 dynamics in predicting disease relapse and monitoring treatment response in stage I-III pancreatic ductal adenocarcinoma: An interim analysis of a prospective observational study.
Zou S, Li F, Xu LD, +7 more, Zhan Q.
AI summary — for doctors, generated from the abstract only
In resected pancreatic cancer, longitudinal ctDNA outperformed CA19-9 for predicting relapse, and combining the two improved monitoring of treatment response.
What was studied
An interim analysis of a prospective observational cohort of 136 patients with resected stage I-III PDAC receiving adjuvant chemotherapy, with serial ctDNA and CA19-9 testing.
Key findings
- ctDNA was a stronger independent prognostic factor than CA19-9
- ctDNA positivity on treatment or during surveillance had a 91.7% positive predictive value for relapse
- Combining CA19-9 with ctDNA improved discrimination of responders vs non-responders (HR 3.72; P=.008)
- A dynamic ctDNA score achieved AUCs of 0.87 (1-year) and 0.82 (2-year) for DFS
Clinical relevance
This supports dual-biomarker postoperative surveillance in PDAC as a promising approach. It is an interim single-cohort analysis and does not establish whether acting on results improves outcomes.
Who should care
Limitations
Interim analysis of a moderate single cohort, likely single-center; no external validation; observational.
Serial ctDNA plus CA19-9 may detect pancreatic cancer relapse earlier than CA19-9 alone.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Introduction
Postoperative recurrence is the leading cause of mortality in resected pancreatic ductal adenocarcinoma (PDAC), yet reliable tools for early relapse detection and treatment response assessment remain lacking.
Methods
In a prospective cohort of 136 patients with resected stage I-III PDAC receiving adjuvant chemotherapy, we evaluated circulating tumor DNA (ctDNA) and CA19-9 as longitudinal biomarkers across multiple postoperative time windows.
Results
ctDNA consistently outperformed CA19-9 as an independent prognostic factor; ctDNA positivity at on-treatment and surveillance assessments achieved a positive predictive value of 91.7%, while persistent negativity identified the lowest-risk patients. Integrating CA19-9 with ctDNA resolved the ctDNA-alone gap in distinguishing treatment clearance from conversion, improving discrimination of responders from non-responders (HR 3.72; P = .008). A time-weighted dynamic ctDNA risk score (MinerVa-dynamic) further stratified ctDNA-negative patients into clinically distinct prognostic subgroups, achieving an area under the curve of 0.87 and 0.82 for one- and two-year disease-free survival prediction, respectively.
Conclusions
These findings support a dual-biomarker longitudinal monitoring framework as a practical, individualized approach to postoperative surveillance and early therapeutic decision-making in PDAC.
DOI
10.1016/j.ejca.2026.117042
PMID
42743887
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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