Early ctDNA molecular response enhanced through integrated analyses of cell-free DNA and matched white blood cells

Liquid biopsies represent a transformation in the management of cancer as they have the potential to detect, characterize, and monitor cancers earlier than conventional diagnostic modalities. Analyses of circulating tumor DNA (ctDNA) have shown promise in capturing tumor burden dynamics during therapeutic intervention to rapidly identify patients with primary resistance and redirect them to alternative therapies. However, cell-free DNA (cfDNA) alterations can be derived from the tumor, germline, or may be associated with clonal hematopoiesis (CH), which can confound noninvasive tumor profiling, molecular response assessment, and clonal evolution analyses through inaccurate variant classification.