“Clearance” requires a detectable baseline and a defined clock
by Tala Benor
In evaluating ctDNA clearance after immune checkpoint inhibition with radiotherapy, the denominator matters: patients without detectable pretreatment ctDNA cannot demonstrate molecular clearance. Post-treatment sampling should be indexed separately to immunotherapy and radiotherapy, with DNA input, assay limits, and intervening imaging reported. Otherwise, an apparent cleared state may combine biological response with low baseline shedding or an insensitive collection window.
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