MINIMAL residual disease (MRD) after initial treatment of advanced ovarian cancer remains a critical hurdle to curing the disease. A recent study has demonstrated the value of detecting MRD using two complementary methods, second-look laparoscopy (SLL) and circulating tumor DNA (ctDNA) testing, at the end of first-line therapy to better predict patient outcomes and guide future treatments.
Researchers evaluated 95 patients with high-grade epithelial ovarian cancer who achieved a complete clinical response following standard therapy. Nearly 42% of these patients had MRD detected through minimally invasive second-look laparoscopy. Those with surgically identified MRD experienced significantly shorter progression-free survival (7.4 months vs. 23.8 months) and overall survival (33.9 months vs. not reached; P < 0.001) compared to patients without detectable MRD. The presence of MRD by SLL was an independent predictor of poorer overall survival.
Among 44 patients who also underwent ctDNA testing, 34% tested positive for residual circulating tumor DNA, which was similarly linked to worse progression-free and overall survival.
Advanced spatial multiomics profiling of MRD lesions further unveiled molecular mechanisms such as hypoxia pathways and immune exclusion, alongside identification of several druggable targets including CDK6 and ERBB2.
These findings suggest that nearly half of patients considered in remission may harbor residual disease detectable by sensitive techniques, offering key prognostic information and potential avenues for novel targeted therapies and clinical trials aimed at eradicating these resistant cancer cells.
This research marks a crucial step toward personalized ovarian cancer treatment through early, precise detection of minimal residual disease.
Reference
Knisely A et al. Surgical and blood-based minimal residual disease in patients with ovarian cancer after first-line therapy: clinical outcomes and translational opportunities. Clin Cancer Res. 2025; doi: 10.1158/1078-0432.CCR-25-0512.
