Evaluate the Prognostic Value of Non–Small-Cell Lung Cancer Using Blood-Based Circulating Tumor DNA: A Systematic Review and Meta-analysis

Background and objectives: This research aimed to evaluate the prognostic value(s) of non-small-cell lung cancer (NSCLC) through blood-based circulating tumor DNA (ctDNA). Material and methods: To achieve the objectives of the study, databases at the international scale, including Web of Science, PubMed, Science Direct, Wiley, Scopus, EBSCO, Web of Knowledge, ISI, Embase, Google Scholar, and Elsevier, were searched according to PRISMA 2020-27-item checklist and respective keywords from 2019 to February 2024. Moreover, the inverse–variance method and the fixed-effect model were applied in the research. In addition, we used STATA/MP v17 for statistical analyses of the data (Sig, ˂ 0.05). Results: Based on the search, 11 articles were chosen, considering the inclusion criteria intended for the research. The analysis demonstrated that cases suffering from higher levels of ctDNA exhibited greater levels of risk for progression-free survival and overall survival (HR 3.47, 95% CI 2.98-3.97; P-value < 0.001) and (HR 3.16, 95% CI 2.45-3.87, P-value < 0.001) than that of the cases suffering from lower levels of ctDNA. Conclusions: Positive ctDNA was found to be related to overall survival and progression-free survival individually and collectively in non–small–cell Lung Cancer cases.