Dr Dalia Kaakour speaks to ecancer about use of circulating tumour DNA (ctDNA) in the detection of residual disease and recurrence for patients with testicular cancer.

This retrospective study evaluated 41 patients with any stage or histology of testicular cancer treated between 2020 and 2025, collecting 153 ctDNA samples using the Natera assay.

The findings showed ctDNA demonstrated 100% sensitivity (95% CI 79.4–100%) and 100% specificity (95% CI 97.2–100%) across stages I–III for both residual disease and relapse.

In 8 discordant cases, ctDNA either detected relapse earlier than imaging or correctly indicated absence of disease when imaging was falsely positive.

Furthermore, ctDNA performed well in both seminoma and non-seminoma patients.

Dr Kaakour says that these results suggest ctDNA is a highly reliable biomarker for testicular cancer surveillance, with better performance than conventional serum markers and imaging. Its rapid half-life and precision make it a practical tool for monitoring treatment response and early relapse.