Genomic alterations and dynamic molecular residual disease monitoring predict pathological response to neoadjuvant chemoimmunotherapy in esophageal squamous cell carcinoma.

Although a higher proportion of smokers was observed in non-MPR group, this trend failed to reach statistical significance.

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In conclusion, the status of plasma MRD after the completion of NCIT (P3) proved to be more effective than that on the therapy (P2) in predicting pathological responses; specifically, the MRD status (positive or negative), the ctDNA level (maxVAF or ctDNA concentration), and the magnitude of ctDNA clearance relative to baseline in P3 showed a significant correlation with pathological efficacy ( Figures 3C, D ; Supplementary Figures S3E–H ), whereas these metrics at P2, including the dynamic changes from baseline, did not reach statistical significance ( Figure 3D ; Supplementary Figures S3A–D ).

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