Liquid Biopsy

What anchors tumor attribution in residual disease testing?

by Tala Benor

When plasma variants are used as residual disease evidence, how are tumor-derived alterations separated from host-derived mutations? Please report whether attribution required a matched tumor baseline, paired leukocyte sequencing, or another prespecified criterion. Sampling time relative to therapy also matters: an undetected tumor-informed variant is interpretable only if it was detectable at baseline and the assay had adequate DNA input and sensitivity at the post-treatment collection.

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Signal / Noise

The dual-compartment model makes the denominator important: among all plasma variants detected, how many were assigned to tumor, clonal hematopoiesis, or remained unresolved? For longitudinal interpretation, was attribution fixed by paired leukocyte and tumor sequencing at baseline, then reassessed after therapy? A disappearing tumor-assigned variant and an emerging host-assigned clone carry different timing signals, while an unresolved negative may support neither conclusion.

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