Benefits and limitations of ctDNA-based technology for the assessment of immunotherapy response

BenefitsLimitations
Reduction in ctDNA levels associated with overall survival and progression-free survivalComorbidities can affect ctDNA levels (smoking, pregnancy, heart disease, inflammation)
Detection of immunotherapy response after about 8 weeksClonal hematopoiesis
Allows for serial monitoring to detect developing resistance and genomic variantsVariable ctDNA fraction based on primary malignancy and stage
Non-invasive detection (blood test)Multiple assays to choose from with no standardization
Comprehensive, patient-specific molecular profilingWide variability in cost
-Concordance between aberrations detected in ctDNA and tumor tissue
-Low concentration and fragmentation
-Unable to detect genomic fusion events and copy number changes

ctDNA: circulating tumor DNA; -: no data