Challenges and Future Directions in ctDNA-Guided Care

Panelists discuss key challenges and future directions for ctDNA-guided therapy across GU malignancies. A major focus is the lack of robust data in certain patient populations, such as those with upper tract urothelial carcinoma, where limited tissue availability complicates tumor-informed testing. Clinicians also highlight the need for prospective trials to validate ctDNA-driven treatment escalation and de-escalation strategies. Emerging technologies, including tumor-uninformed assays and whole-genome approaches, may help overcome current limitations and expand clinical applicability. The segment emphasizes the importance of integrating ctDNA into clinical trial design to generate high-level evidence. As the field advances, ctDNA has the potential to transform patient selection and treatment personalization, but widespread adoption will depend on continued validation and standardization.