Combined ctDNA and serum PSA for dynamic monitoring of metastatic prostate cancer starting first-line treatment: a prospective national cohort study - Summary - MDSpire

Combined ctDNA and serum PSA for dynamic monitoring of metastatic prostate cancer starting first-line treatment: a prospective national cohort study

  • By

  • Anuradha Jayaram

  • Memuna Rashid

  • Alison H. M. Reid

  • Francesco Orlando

  • Suparna Thakali

  • Leila Zakka

  • Miriam Goncalves

  • Jacqueline O’Dwyer

  • Constantine Alifrangis

  • Rob Jones

  • Elias Pintus

  • Sarah Needleman

  • Diletta Bianchini

  • Anna Wingate

  • Kenrick Ng

  • Mark Linch

  • Ursula McGovern

  • John Staffurth

  • Simon J. Crabb

  • Susannah Brock

  • Alison Birtle

  • Osvaldas Vainauskas

  • Gianmarco Leone

  • Millenn Chiwewe

  • Allan Hackshaw

  • Andre Lopes

  • Daniel Wetterskog

  • Francesca Demichelis

  • Gerhardt Attard

  • May 15, 2026

  • 0 min

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Objective:

To evaluate the utility of combining circulating tumor DNA (ctDNA) analysis with serum PSA testing for improving patient stratification and treatment decisions in metastatic castration-sensitive prostate cancer (mCSPC), potentially impacting treatment outcomes.

Key Findings:
  • 29% of patients had detectable ctDNA at cycles 3 or 4 (p-value needed).
  • The median ctDNA fraction among ctDNA-positive patients was 0.03.
  • 52% of patients had a PSA level between 0.2 and 4 ng ml−1, while 27% had a PSA level > 4 ng ml−1.
Interpretation:

Combining ctDNA with PSA testing may enhance the ability to identify patients at high risk of relapse, potentially allowing for timely treatment modifications, which could improve patient outcomes.

Limitations:
  • The study's sample size was limited to 117 patients, which may affect the generalizability of the results.
  • The analysis was restricted to specific treatment cycles, which may not capture the full treatment response and could introduce biases.
Conclusion:

The integration of ctDNA analysis with PSA testing shows promise for real-time assessment and management of mCSPC, warranting further investigation in larger cohorts to validate these findings.

Original Source(s)

Combined ctDNA and serum PSA for dynamic monitoring of metastatic prostate cancer starting first-line treatment: a prospective national cohort study

  • by Anuradha Jayaram, Memuna Rashid, Alison H. M. Reid, Francesco Orlando, Suparna Thakali, Leila Zakka, Miriam Goncalves, Jacqueline O’Dwyer, Constantine Alifrangis, Rob Jones, Elias Pintus, Sarah Needleman, Diletta Bianchini, Anna Wingate, Kenrick Ng, Mark Linch, Ursula McGovern, John Staffurth, Simon J. Crabb, Susannah Brock, Alison Birtle, Osvaldas Vainauskas, Gianmarco Leone, Millenn Chiwewe, Allan Hackshaw, Andre Lopes, Daniel Wetterskog, Francesca Demichelis, Gerhardt Attard

  • May 15, 2026

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