Competing Interests

JT and SS: Guardant Health (employees and stockholders); HX: Cardiff Oncology (institution), Dynamicure (institution), BioNTech SE (institution), Qurient Therapeutics (institution), SparX Biopharmaceutical Corp (institution), and Xilio Therapeutics (institution). Khalid Jazieh, Katrina S. Pedersen, and Martin E. Fernandez-Zapico declare that they have no conflicts of interest that might be relevant to the contents of this manuscript.

Ethics Approval

The first cohort (Guardant “national cohort”) was a deidentified dataset made available by Guardant Health (Palo Alto, CA, USA) for research purposes, with approval from the Advarra Institutional Review Board (Pro00034566). The second cohort consisted of patients with advanced or metastatic PDAC or CRC tested with Guardant360 assays at the Mayo Clinic from January 2016 to June 2023 (“Mayo cohort”), approved by the institutional review board (23-005258).

Consent to Participate/Consent to Publish

Not applicable.

Data Availability

Data, analytic methods, and study materials will or will not be made available to other researchers upon request to corresponding author Dr. Hao Xie.

Code Availability

Not applicable.

Author Contributions

Khalid Jazieh: conception, design, data analysis, and manuscript preparation; Jill Tsai: conception, design, data analysis, and manuscript review; Sheila Solomon: data analysis and manuscript review; Mojun Zhu and Katrina S. Pedersen: manuscript review; Martin E. Fernandez-Zapico: design and manuscript review; Hao Xie: conception, design, and manuscript preparation and review.