Beyond prostate-specific antigen: ctDNA as an early compass for treatment adaptation in metastatic prostate cancer

In a recent study published in Nature Cancer , Jayaram and colleagues 1 demonstrated that persistent circulating tumor DNA detection during first-line intensified therapy independently predicts poor survival in patients with metastatic castration-sensitive prostate cancer, providing prognostic information earlier than prostate-specific antigen (PSA) kinetics. These findings support circulating tumor DNA as a promising dynamic biomarker for early treatment adaptation and highlight its potential to complement PSA in guiding precision therapeutic strategies.