Plasma circulating tumor deoxyribonucleic acid methylation enables noninvasive disease stratification beyond prostate-specific antigen in prostate cancer

Background

Accurate discrimination between localized and metastatic prostate cancer (PCa) remains a critical unmet need in clinical practice, particularly in patients with equivocal imaging findings or biologically high-risk disease. Circulating tumor DNA (ctDNA) methylation represents a stable epigenetic signal that may reflect tumor burden and disease state. We aimed to evaluate whether plasma ctDNA methylation markers can accurately discriminate disease state beyond conventional clinical parameters.