The FDA approved atezolizumab (Tecentriq) and atezolizumab/hyaluronidase-tqjs (Tecentriq Hybreza) as adjuvant treatment for adults with muscle-invasive bladder cancer (MIBC) after cystectomy who have circulating tumor DNA (ctDNA)-based molecular residual disease (MRD), as determined by an FDA-authorized companion diagnostic test (Signatera CDx, approved alongside it) — the first ctDNA-MRD-GUIDED adjuvant immunotherapy approval in oncology, meaning treatment is targeted specifically to patients whose blood tests show detectable cancer DNA after surgery, rather than given to everyone regardless of that result. The approval was based on the randomized, double-blind, placebo-controlled, phase 3 IMvigor011 trial (ClinicalTrials.gov NCT04660344; primary publication in the New England Journal of Medicine, DOI 10.1056/NEJMoa2511885, PMID 41124204), which enrolled 250 patients with MIBC who had ctDNA MRD detected by serial blood testing within 12 months of cystectomy. Atezolizumab reduced the risk of disease recurrence or death by 36% and the risk of death by 41% compared with placebo in this ctDNA-positive population — a real, disclosed, biomarker-selected benefit.

A prospective cohort study reports that KRAS circulating tumor DNA (ctDNA) is associated with metastasis and survival outcomes in pancreatic cancer. Primary publication: PMID 40067610, https://pubmed.ncbi.nlm.nih.gov/40067610/, DOI https://doi.org/10.1245/s10434-025-17036-y. This is a biomarker/prognostic study, not a treatment. ctDNA is not itself a treatment, and an association between a biomarker and outcomes is not itself proof that changing clinical management based on the test result improves survival — that would require a dedicated interventional/outcomes study. [Identifiers as supplied, attributed to independent verification outside this environment — not independently re-verified live here.]