Methylated cell-free DNA sequencing to identify early progression in metastatic renal cell carcinoma patients on watchful waiting.

Watchful waiting (WW) is a feasible option for patients with good or intermediate prognosis clear cell renal-cell carcinoma (RCC). However, some patients rapidly progress during WW, requiring initiation of systemic treatment. Here, we aim to identify those patients at risk of rapid progression during WW using circulating cell-free DNA (cfDNA) and methylated DNA sequencing (MeD-seq).