Monitoring ctDNA levels to predict therapy response

On Wednesday the 24th of June, Henrik Ditzel and Julia Sidenius Johansen invited the DCCC ctDNA research center members to join an online meeting under the clinical focus area 4 (CFA4) about monitoring ctDNA levels to predict therapy response.

The purpose of the meeting was to keep all members updated on projects relevant to this clinical area.

The projects seek to investigate whether monitoring ctDNA levels during treatment is a better measure of treatment efficacy compared to standard imaging methods and other circulating biomarkers. Furthermore, the meeting supports the formation of a strong network. An important goal for the DCCC ctDNA research center is to ensure formation of new projects and collaborations across Denmark. This is a place to meet fellow researchers and doctors, who could complement your project or benefit from learning from you.

At this meeting, Professor Lars Dyrskjøt gave a short introduction to some methods for ctDNA detection and covered the following methods:

  • ddPCR based on clonal mutations from tumors: May be used both retrospectively and prospectively
  • Tumor informed targeted sequencing: Primarily used retrospectively
  • Cancer type specific targeted sequencing: May be used retrospectively and prospectively
  • Whole exome sequencing and whole genome sequencing may be used to detect new mutations when ctDNA levels are high: Used both retrospectively and prospectively

If you want to know more about specific methods, please reach out to the ctDNA network at an upcoming meeting or make direct contact. (See the planned meetings and workshops here)


An important topic, discussed at all the meetings this week, was funding applications. Not only in relation to the fall-call from the ctDNA center, but also funding in general. For the next round of funding from the ctDNA center the deadline is 23 October 2020. The guidelines for funding through the ctDNA center are found here: The application and evaluation process will be a bit different for this round but the requirements will not change. The bar was set high for the first round, and this will not change. Receiving funding from the ctDNA center is to receive a sign of approval from peer researchers and thus an argument for funding from other agencies. More information about the new application and evaluation process will come later.

CFA4 Projects

At this meeting, three projects were introduced: TOMBOLA, PACTO, and Be To-Ovar.

TOMBOLA (Treatment Of Metastatic Bladder cancer at the time Of biochemical reLApse following radical cystectomy) Professor Lars Dyrskjøt:

The TOMBOLA trial is a non-randomized phase II study covering multiple CFAs. The intervention occurs after surgery (CFA2) and during surveillance(CFA3) and with a primary  endpoint (ctDNA decrease) during treatment (CFA4). The aim of the study is to investigate whether an earlier detection of relapse and following earlier onset of treatment will result in treatment that is more effective, measured by a decrease in ctDNA levels. For each patient included, four patient specific ddPCR assays are run. Prior to trial onset, the group has focused on optimization, SOP and protocols – if you would like inspiration for your own SOP or protocols, please contact the group. At the next meeting we hope to see the first data from the project.

PACTO (A multinational, randomized, phase II study of the combination of nab-paclitaxel and gemcitabine with or without IL-6R inhibitor, tocilizumab, as first-line treatment in patients with locally advanced or metastatic pancreatic cancer” (NCT02767557))

Inna Chen:

The PACTO study is a trial investigating the effects of chemotherapy in combination with anti-IL-6R inhibitor in patients with locally advanced and metastatic pancreatic cancer. It is a multinational, randomized phase II study. The project includes patients from Herlev (initiating hospital), Hillerød, Roskilde and Oslo.

The patients are followed with CT scans and blood samples before, during and after treatment to investigate whether plasma ctDNA and ctDNA KRAS mutation can predict treatment response and prognosis. The project has almost included all patients.


Clinical Professor Anders Jakobsen:

The BeTo-Ovar project is a phase II protocol monitoring on the basis of ctDNA.

  • Health Economic Consultation

    As part of the national DCCC ctDNA research center all memebers have access to health economic guidance. You can book a session directly with Liza Sopina ( you can have a discussion on how health economics are incoorporated in your project. Liza is available between 10:00 and 13:00. Other times/dates can also be arranged, please contact Liza ( directly to book. 08 Sept 15 Sept 22 Sept 29 Sept 13 Oct 20 Oct 03 Nov Please book a 1:1 consultation if you need help with: Understanding whether economic evaluation is relevant and applicable to your study/trial Planning for and integrating economic evaluation (and relevant data collection) into your study Input into protocol or funding application Planning for a sufficient budget for economic evaluation of your trial/study Any other economic evaluation-related questions you may have! The session are online.
  • Funding application deadline

    You can apply for funding through the ctDNA center for your research project focusing on ctDNA guided intervention or development of new methods or knowledge relevant for the entire center. Deadline September 26th 2022 Find more information and the applicationform here:
  • PhD course

    The ctDNA center will host a ctDNA PhD course at Sandbjerg on May 22 - 23 2023. There are room for a maximum of 20 students. More information will follow.
  • International Symposium and Annual meeting 2022

    We look forward to welcome you to the 1st International Symposium on Circulating Tumor DNA and the Annual Meeting in the Danish National Center for Circulating Tumor DNA Guided Cancer Treatment.  Date: It will take place on the 14-15th of November 2022 November 14 2022, we will have the International Symposium with talks updating us on ctDNA research internationally November 15 2022, the Annual Meeting in the ctDNA center and the meeting in the Steering Committee will take place   Place: HUONE (Amager Strandvej 390, 2770 Kastrup, Copenhagen, Denmark)Please find information about arrival and parking at the bottom of this page: Arrival information   Participation: Please register here for both days: RegistrationDeadline September 30 2022Participation is free.The International Symposium is open for everyone. The Annual Meeting is primarily for members of the DCCC ctDNA center and other interested (eg. from DCCC, The Danish Cancer Society, patient representatives)   Poster and abstract: It is possible to bring a poster. During the International Symposium there will be a poster session, and at the Annual Meeting it will be possible to look around at the posters.If you bring a poster, please submit an abstract too. Among the submitted abstracts we will select a few for a 15-minute talk at the International Symposium.It is possible to register poster and upload an abstract in the registration. Poster size: max.: W.: 92 cm, H.: 138 cm   Tentative program: The tentative programs for the International Symposium and the Annual Meeting is to be found here: 1st International Symposium on Circulating Tumor DNA Annual Meeting in the Danish National Center for Circulating Tumor DNA Guided Cancer Treatment   Contact information:Anne Lærke Lorentzen, Scientific CoordinatorE-mail: +45 78 45 53 39  
  • PhD course

    The ctDNA center will host a ctDNA PhD course at Sandbjerg 3-4 May 2022. There is room for a maximum of 20 students. You can find more information and register here: Remember, both to register via the link and to send your motivated application to - the deadline is 28 February 2022. The center will pay for accomodation for center members.
  • Meeting in the Steering Committee

    The steering committee will meet online on Thursday the 28th of April to discuss the incoming applications for funding from the center, and the assessments from the executive committee. The meeting will be online and it is possible for members of the steering committee to transfer their votes to the chairman of the steering committee (Lars Dyrskjøt Andersen)  Deadline for application for funding is the 7th of March
  • ctDNA and CTC training school

    ctDNA and CTC training school

    The COST Action CA17118 (TRANSCOLONCAN), Tracepigen, the DCCC Nation Research Center for ctDNA guided cancer, and the European Liquid Biopsy Society invite you to apply for participation in the training school for detection and analysis of circulating tumor DNA (ctDNA) and circulating tumor cells (CTC). The training school took place at Aarhus University Hospital in Denmark on March 28-30 2022. The training school invited 35 students from all over Europe to three days of lectures, networking, and a lot of discussions.Thank you to all lecturers and participants.   Download the lectures here: Lecture_1           Lecture_2           Lecture_3                     Lecture_4 Lecture_5           Lecture_6           Lecture_7                     Lecture_8 Lecture_9 part1                           Lecture_9 part2 Lecture_10 part1                         Lecture_10 part2 Lecture_10 part3                         Lecture_10 part4 Lecture_10 part5                        Lecture_11  
  • Medical Biotechnology and Drug Development

    On February 8 2022 a group of American students studying a semester abroud at University of Copenhagen, will visit the ctDNA research center at department of molecularmedicin, AUH. They will get an introduction to the center and ctDNA based intervention studies. We are looking forward to the visit!