{
  "abstract": "Background: Systemic sclerosis (SSc) and dermatomyositis (DM) are autoimmune diseases that have been proposed as models of cancer immunoediting. Autoantibody-defined subsets show divergent cancer risks, yet malignancy often remains clinically occult. We tested whether circulating tumor DNA (ctDNA) can reveal subclinical cancer in new-onset SSc and DM. Methods: We prospectively recruited adults with recent SSc or DM onset. Plasma ctDNA was assessed using a targeted next-generation sequencing panel covering commonly mutated cancer genes. Patients were followed for 18-24 months on average. ctDNA positivity was correlated with subsequent cancer diagnoses. Findings: Among 134 patients (69 SSc, 65 DM), cancer was diagnosed in six (4.5%; three SSc, three DM). ctDNA was detected in four of these six patients (67%) a median of 13 months (range 1.4-17) before clinical diagnosis; in three of four patients, mutations detected in plasma matched those subsequently identified in the same patients primary tumors. ctDNA was also detected in 16 of 128 patients without a cancer diagnosis. ctDNA positivity conferred an 11.4-fold higher risk of malignancy relative to ctDNA negativity and yielded a negative predictive value of 98% and a positive predictive value of 20% for cancer within the observation window. Interpretation: ctDNA testing identified most cancers that emerged within 18 months in new-onset SSc and DM and stratified near-term cancer risk. These findings support larger, interventional trials to determine whether ctDNA-guided surveillance improves timeliness of cancer detection, optimizes imaging and biopsy strategies, and enhances outcomes in patients with SSc and DM.",
  "abstract_shown": true,
  "affiliations": [
    "Johns Hopkins University School of Medicine"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 26,
  "authors": [
    {
      "name": "C. A. Mecoli"
    },
    {
      "name": "Y. Wang"
    },
    {
      "name": "J. S. Kim"
    },
    {
      "name": "X. Wang"
    },
    {
      "name": "A. Woods"
    },
    {
      "name": "C. Douville"
    },
    {
      "name": "S. D. Curtis"
    },
    {
      "name": "M. Popoli"
    },
    {
      "name": "J. Ptak"
    },
    {
      "name": "L. Dobbyn"
    },
    {
      "name": "N. Silliman"
    },
    {
      "name": "M. B. Smith"
    },
    {
      "name": "L. Fisher"
    },
    {
      "name": "G. Leatherman"
    },
    {
      "name": "L. K. Hummers"
    },
    {
      "name": "L. Christopher-Stine"
    },
    {
      "name": "J. J. Paik"
    },
    {
      "name": "J. Albayda"
    },
    {
      "name": "F. M. Wigley"
    },
    {
      "name": "A. Rosen"
    },
    {
      "name": "L. Casciola-Rosen"
    },
    {
      "name": "C. Bettegowda"
    },
    {
      "name": "N. Papadopoulos"
    },
    {
      "name": "K. W. Kinzler"
    },
    {
      "name": "B. Vogelstein"
    },
    {
      "affs": [
        0
      ],
      "name": "A. A. Shah"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/67caqh1y9vwp7.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.11.06.26364657",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.11.06.26364657v1.full",
  "id": "67caqh1y9vwp7",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.11.06.26364657v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "rheumatology"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.11.06.26364657v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-06",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/67caqh1y9vwp7.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T00:20:58Z",
      "native_id": "10.64898/2026.11.06.26364657",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.11.06.26364657v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:rheumatology",
      "subfield": "general"
    }
  ],
  "title": "Circulating Tumor DNA in Patients with Early-Onset Systemic Sclerosis and Dermatomyositis",
  "title_text": "Circulating Tumor DNA in Patients with Early-Onset Systemic Sclerosis and Dermatomyositis",
  "type": "preprint",
  "updated_at": "2026-11-08T00:20:58Z",
  "url": "https://research.draconitic.com/paper/67caqh1y9vwp7",
  "venue": "medRxiv",
  "versions": []
}