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Decoding minimal residual disease

Listen to the podcast episode: Decoding minimal residual disease (22 minutes)

Minimal residual disease (MRD) testing is an emerging tool in precision oncology that can provide insights beyond traditional imaging and clinical assessment. In this episode, Rebecca Johnson Wheeler, MS, CGC, and Dr CK Wang explore how circulating tumor DNA (ctDNA) can be used to detect residual disease and discuss how MRD results may help inform recurrence risk, treatment response, and disease surveillance and explore the growing role of MRD testing in cancer care.

This episode will

  • Define minimal residual disease and describe how circulating tumor DNA (ctDNA) can be used to detect evidence of cancer that may remain after treatment  (4:08)
  • Differentiate tumor-informed and tumor agnostic MRD approaches to testing, and what to consider when selecting an MRD test. (5:57)
  • Explain the clinical significance of MRD results and its clinical utility in muscle invasive bladder cancer care through a case example (9:36)
  • Recognize current and emerging clinical applications of MRD testing (16:00)

Speakers: Rebecca Johnson Wheeler, MS, CGC; CK Wang, MD

Contributors: Rebecca Johnson Wheeler, MS, CGC; CK Wang, MD; Jared Snider, PhD; Mark Reed, PhD

Episode released November 1,  2026

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References

  1. National Comprehensive Cancer Network®. Bladder Cancer (Version 3.2026). Published August 2026. Accessed October 2, 2026. https://www.nccn.org
  2. Tie J, Wang Y, Lo SN, et al. Circulating tumor DNA analysis guiding adjuvant therapy in stage II colon cancer: 5-year outcomes of the randomized DYNAMIC trial. Nat Med. 2025;31(5):1509-1518. doi:10.1038/s41591-025-03579-w
  3. Tie J, Cohen JD, Lahouel K, et al. Circulating tumor DNA Analysis guiding adjuvant therapy in stage II colon cancer. N Engl J Med. 2022;386(24):2261-2272. doi:10.1056/NEJMoa2200075
  4. Powles T, Kann AG, Castellano D, et al. ctDNA-guided adjuvant atezolizumab in muscle-invasive bladder cancer. N Engl J Med. 2025;393(24):2395-2408. doi:10.1056/NEJMoa2511885
  5. Zhou H, Zhu L, Song J, et al. Liquid biopsy at the frontier of detection, prognosis and progression monitoring in colorectal cancer. Mol Cancer. 2022;21(1):86. doi:10.1186/s12943-022-01556-2
Hosted by Rebecca Johnson Wheeler, MS, CGC
Featuring CK Wang, MD

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