Circulating Tumor DNA (ctDNA)

ctDNA for Monitoring Treatment Response (ctMoniTR) Project

Recent Updates: Friends of Cancer Research, in partnership with 25 organizations, has successfully launched Step 2 of the ctMoniTR Project. Click HERE to read the press release.

ctDNA (circulating tumor DNA) is genetic material from cancer cells naturally found in the bloodstream.

ctDNA to Monitor Treatment Response (ctMoniTR) is a first of its kind partnership led by Friends of Cancer Research (Friends) to answer the question: Do changes in ctDNA reflect response to treatment?

To sign up for updates on ctMoniTR, including release of analyses, click here.

  • What is ctMoniTR?

    One of the largest-scale scientific endeavors in Friends history to assess the ability of a rapid and easy-to-use blood test to monitor treatment response.

  • How is this unique?

    We are collecting data from multiple clinical trials to determine if changes in the amount of tumor DNA found in the blood stream (ctDNA) can accurately predict whether a drug is working.

  • Who is involved?

    Friends is leading a multi-stakeholder research project with multiple pharmaceutical companies, diagnostic labs, government health officials, patient advocates, and academic researchers.

  • Why is this important?

    The ctMoniTR Project will validate whether blood markers can be used to easily and more rapidly determine whether a drug is working. By getting this information quickly and in a less invasive way, physicians and patients will understand if the treatment is working or if they should change treatments. This will also accelerate research by enabling quicker identification of new treatments that show a rapid anti-tumor effect and ultimately reach patients sooner.

ctMoniTR Step 1 - Click HERE for our Results Announcement Recap
Step 1 of ctMoniTR brought together clinical and academic leaders, government, industry, and leading advocates to align on a methodology to combine data from multiple past clinical trials in lung cancer investigating immune checkpoint inhibitors as an initial case study.  Step 1 has created a combined dataset larger than if any one stakeholder attempted this alone and from which we will more reliably investigate changes in ctDNA as a marker of treatment response. 

  • Click HERE to view our event recaps from the Friends of Cancer Research Virtual Meeting: Do changes in ctDNA reflect response to treatment? and the August 25th Virtual Q&A, Building ctMoniTR: Step 1 Questions and Step 2 Goals

ctMoniTR Step 2 - Click HERE for the Step 2 Project Launch Announcement
Building on the results from Step 1, Friends will expand the scope of this unique partnership to determine feasibility in other cancer types, generating results in a much shorter timeframe. Step 2 will seek to confirm the preliminary results, and show, on a broad scale, that disparate data can be aligned to verify whether ctDNA can be used as a rapid tool to allow physicians and patients to know sooner and more accurately if a treatment is working.

The Background

  • This project builds off of Friends' previous work in the field, including the Friends Annual Meeting 2018 whitepaper
  • Building on the whitepaper and feedback from the 2018 Annual Meeting, Friends developed a proposal for this project. In February of 2019, Friends hosted a full-day roundtable meeting to review the proposal, ultimately reaching consensus to execute the collaborative project. Click HERE to view this proposal.


Friends of Cancer Research is proud to partner with the following 25 organizations on Step 2 of the ctMoniTR Project: AstraZeneca, Bayer, Biodesix, Boehringer Ingelheim, Bristol Myers Squibb Company, Cancer Research And Biostatistics (CRAB), EMD Serono, Inc., US Food and Drug Administration (FDA), Foundation Medicine, Inc., Genentech, Inc., Guardant Health, Inc., Illumina, Inc., Johns Hopkins University, Lilly Oncology, Merck & Co. Inc., Molecular Characterization Laboratory at Frederick National Laboratory, Memorial Sloan Kettering Cancer Center, Natera, Inc., NMD Group LLC., Novartis AG, Pfizer, Inc., Princess Margaret Cancer Centre, Regeneron Pharmaceuticals Inc., Resolution Bioscience, Inc., Takeda Pharmaceutical Company

10 partners participated in Step 1 of the ctMoniTR Project, including: AstraZeneca, Bristol-Myers Squibb, Genentech, Guardant Health, Johns Hopkins University, LexentBio, Merck, the NMD Group LLC, Penn Medicine, Roche Dx, and the U.S. Food and Drug Administration.