{"entity":{"id":"paper-zhou-minerva-prime-evidence-nat-commun-2026","kind":"paper","name":"Clinical utility of molecular residual disease detection in early-stage resected EGFR-mutated non-small cell lung cancer","aka":[],"tldr":"In the EVIDENCE trial of resected EGFR-mutated lung cancer, a blood test for leftover cancer picked out patients at higher risk of relapse, and icotinib helped whether or not it was positive.","summary":"MRD analysis of the phase 3 EVIDENCE trial in stage II to IIIA resected EGFR-mutated non-small cell lung cancer treated with adjuvant icotinib or chemotherapy: 1,352 plasma samples from 175 patients analysed with MinerVa Prime. Landmark positivity was 35.8 per cent (38 of 106) in stage III and 14.7 per cent (10 of 68) in stage II, longitudinal positivity 47.4 per cent. Positivity was associated with shorter disease-free survival at the landmark (hazard ratio 4.44) and in longitudinal monitoring (7.82). Icotinib gave disease-free survival benefit over chemotherapy in both MRD groups. Longitudinal negative predictive value was 91.3 per cent and median lead time 169 days; MRD status at 24 weeks after randomisation was the most prognostic.","asOf":"2026-11-04","links":[{"label":"Zhou et al., Nat Commun 2026","url":"https://doi.org/10.1038/s41467-026-76392-9"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/42706268/"}],"tags":[],"related":[],"cancers":["nsclc"],"sections":["diagnostics"],"technologies":["mrd-testing"],"targets":[],"drugs":["minerva-prime","icotinib"],"companies":["genecast"],"institutions":[],"pathways":[],"terms":["mrd","ctdna","tumour-informed-assay"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nature-communications"],"dependsOn":[],"notes":[],"journal":"Nature Communications","year":2026,"doi":"10.1038/s41467-026-76392-9","pmid":"42706268","authors":"Zhou F, Su C, Liang W, et al.","paperType":"translational","findings":["Landmark positivity 35.8% (stage III) and 14.7% (stage II).","DFS HR 4.44 landmark, 7.82 longitudinal.","NPV 91.3%; median lead time 169 days."],"whatItMeans":"Residual disease testing is prognostic after EGFR lung cancer surgery, but in this trial it did not pick out who benefits from icotinib, since both groups did.","caveats":["Retrospective analysis within a completed trial."],"participants":175},"route":"/key-papers/paper-zhou-minerva-prime-evidence-nat-commun-2026/","neighbours":{"cancer":[{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"section":[{"id":"diagnostics","kind":"section","name":"Diagnostics & Biomarkers","route":"/fronts/diagnostics/"}],"technology":[{"id":"mrd-testing","kind":"technology","name":"MRD / molecular residual disease testing","route":"/technologies/mrd-testing/"}],"drug":[{"id":"icotinib","kind":"drug","name":"Icotinib","route":"/drugs/icotinib/"},{"id":"minerva-prime","kind":"drug","name":"MinerVa Prime","route":"/drugs/minerva-prime/"}],"company":[{"id":"genecast","kind":"company","name":"Genecast Biotechnology","route":"/companies/genecast/"}],"term":[{"id":"ctdna","kind":"term","name":"Circulating tumour DNA (ctDNA)","route":"/terms/ctdna/"},{"id":"mrd","kind":"term","name":"Minimal / molecular residual disease (MRD)","route":"/terms/mrd/"},{"id":"tumour-informed-assay","kind":"term","name":"Tumour-informed versus tumour-naive ctDNA assays","route":"/terms/tumour-informed-assay/"}],"journal":[{"id":"nature-communications","kind":"journal","name":"Nature Communications","route":"/journals/nature-communications/"}]}}