Evidence mapPaperPMID 42344896Full record

SynthesisFrontiers in immunology2026

Prognostic utility of circulating tumor DNA assessment in immune checkpoint inhibitor-treated advanced non-small cell lung cancer: a systematic review and meta-analysis.

Yulin Wang, Shuang Wu, Yanfang Wei, Shize Fan, Zihui Xu, Dongyang Li, Zan Teng, Jin Wang

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yulin WangDepartment of Medical Oncology, the First Hospital of China Medical University, Shenyang, China.
Shuang WuDepartment of Medical Oncology, the First Hospital of China Medical University, Shenyang, China.
Yanfang WeiDepartment of Medical Oncology, the First Hospital of China Medical University, Shenyang, China.
Shize FanDepartment of Medical Oncology, the First Hospital of China Medical University, Shenyang, China.
Zihui XuDepartment of Endocrinology, the First Hospital of China Medical University, Shenyang, China.
Dongyang Li *Department of Medical Oncology, the First Hospital of China Medical University, Shenyang, China.
Zan Teng *Department of Medical Oncology, the First Hospital of China Medical University, Shenyang, China.
Jin Wang *Department of Medical Oncology, the First Hospital of China Medical University, Shenyang, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: This meta-analysis aimed to assess the prognostic value of circulating tumor DNA (ctDNA) in predicting progression-free survival (PFS) and overall survival (OS) of advanced non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs), thereby providing evidence-based support for clinical decision-making. Methods: Six major English and Chinese databases (PubMed, Embase, Cochrane Library, etc.) were scanned from inception to August 2025. Studies evaluating the association between ctDNA and survival outcomes in advanced NSCLC patients receiving ICIs were included. Thirty-one eligible studies (2,107 patients) were selected following predefined criteria. Study quality was evaluated using Cochrane RoB-2 and the Newcastle-Ottawa Scale (NOS). Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were pooled using random/fixed-effects models. Heterogeneity was assessed via Cochran's Q test and I Results: Patients with undetectable ctDNA at baseline showed significantly prolonged PFS (HR = 0.49, 95% CI: 0.34-0.70, P < 0.01) and OS (HR = 0.45, 95% CI: 0.32-0.65, P < 0.01). Patients achieving ctDNA reduction or response during treatment exhibited substantial PFS (HR = 0.27, 95% CI: 0.21-0.35, P < 0.01) and OS (HR = 0.23, 95% CI: 0.17-0.31, P < 0.01) benefits, with complete molecular response (100% reduction in variant allele frequency, VAF) demonstrating the strongest predictive power, characterized by the lowest heterogeneity and favorable HRs for PFS (HR = 0.27, 95% CI: 0.18-0.41, P < 0.01) and OS (HR = 0.19, 95% CI: 0.12-0.29, P < 0.01). Subgroup analyses revealed three key patterns: superior predictive value in combination therapy versus monotherapy; higher sensitivity of next-generation sequencing (NGS) over digital polymerase chain reaction (PCR); and enhanced predictive power in later-line therapy compared to first-line therapy. Sensitivity analyses confirmed the stability of the results. Conclusion: Baseline ctDNA status and early dynamic changes are reliable prognostic indicators in advanced NSCLC patients receiving ICI therapy, particularly in combination regimens and cases achieving complete molecular clearance. These findings support ctDNA as a biomarker for personalized treatment strategies. Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO, CRD420251025308.

Indexed as

Biomarkers, TumorCarcinoma, Non-Small-Cell LungCirculating Tumor DNAImmune Checkpoint InhibitorsLung NeoplasmsHumansPrognosisTreatment OutcomeBiomarkers, TumorCirculating Tumor DNAImmune Checkpoint Inhibitorscirculating tumor DNAimmune checkpoint inhibitorsimmunotherapymeta-analysisnon-small cell lung cancer

Identifiers

PMID42344896
PMCPMC13287079

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.