Can MRD Testing Enable Treatment Breaks in Metastatic GE Cancer?

In an interview with Targeted Oncology, Rutika Mehta, MD, MPH, associate professor of medicine and attending physician at Weill Cornell Medicine and NewYork-Presbyterian Hospital, explains how her new study in Cancer expands on prior studies evaluating molecular monitoring in gastroesophageal cancer.

Watch the first part of Dr Mehta’s interview.

Earlier work had demonstrated the value of circulating tumor DNA (ctDNA)–based detection of minimal residual disease (MRD) as an adjunct tool in the locally advanced setting. Building on those findings, Mehta and colleagues sought to determine whether MRD testing could also provide clinical insights in patients with metastatic disease.

Advances in systemic therapies have improved outcomes in metastatic gastroesophageal cancer, enabling many patients to live longer and achieve deeper responses. As a result, clinicians increasingly face a common clinical dilemma: when imaging shows no evidence of disease, how long should systemic therapy—particularly cytotoxic chemotherapy—be continued?

In her clinical practice, Mehta began incorporating MRD testing to provide an additional layer of reassurance when evaluating treatment response. By assessing ctDNA levels, clinicians may gain molecular evidence that therapy has achieved a deep response, potentially supporting decisions to pause treatment in select patients with metastatic disease.

Encouraged by patterns observed among her own patients, Mehta collaborated with colleagues to systematically evaluate how MRD testing is being used in real-world clinical practice. The resulting multi-institutional effort aimed to better understand 2 key questions: how clinicians are incorporating MRD testing into management strategies for metastatic disease, and whether ctDNA findings correlate with treatment responses and outcomes.

By analyzing these data, the study explores whether MRD status may have prognostic implications, including associations with progression-free survival. Ultimately, the research seeks to clarify how molecular monitoring could help guide treatment duration and inform individualized management decisions for patients with metastatic gastroesophageal cancer.

Read the full interview here.