Original Investigation

ctDNA or Merkel Virus Antibodies for Surveillance of Merkel Cell Carcinoma Recurrence

JAMA Dermatology 10.1001/jamadermatol.2026.2153

July 08, 2026 at 11:00 AM EDT

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When monitoring for recurrent Merkel cell carcinoma, which blood-based test is more accurate: circulating tumor DNA (ctDNA) or Merkel cell polyomavirus antibody testing?In this cohort study of 169 patients with a total of 703 paired tests, a positive ctDNA was more predictive of recurrence than antibody testing, with consistently higher positive predictive value (73% vs 52% at 365 days) and negative predictive value (99% vs 97% at 90 days).Results of this study suggest that ctDNA outperforms antibody testing for detecting recurrent Merkel cell carcinoma.

Corresponding Author: Lisa C. Zaba, MD, PhD, Stanford University School of Medicine, 780 Welch Rd, Ste CJ CJ220I, Palo Alto, CA 94304 (lisa.zaba@stanford.edu).

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