JCO Journals shared on LinkedIn:
“Could serial ctDNA monitoring provide an earlier window into treatment response in early-stage breast cancer?
A prospective pilot study evaluated tumor-informed circulating tumor DNA (ctDNA) before, during, and after neoadjuvant therapy in patients with stage II–III triple-negative or HER2-positive breast cancer. The study enrolled 37 patients; 30 had baseline ctDNA results and were eligible for analysis.
Early ctDNA clearance, within 6 weeks of starting neoadjuvant therapy, was associated with lower postsurgical tumor burden and lower postsurgical ctDNA positivity, a marker of molecular residual disease. Patients with early clearance were significantly more likely to have negative postsurgical ctDNA than those with late or no clearance (P = .0128).
Baseline ctDNA levels also provided a potentially important prognostic signal: levels >10 MTM/mL were associated with a higher risk of molecular and/or clinical relapse, while levels <1 MTM/mL were associated with lower risk.
In multivariable analysis, baseline ctDNA was the only significant prognostic factor for molecular and/or clinical relapse. Levels >10 MTM/mL were associated with higher odds of relapse (OR 14.2; P = .026), while levels <1 MTM/mL were associated with lower odds (OR 0.38; P = .04).
These preliminary findings suggest that serial ctDNA may complement pathologic assessment and support earlier risk stratification. Larger prospective studies are needed before ctDNA monitoring can guide treatment decisions. ”
Title: Predicting Response to Neoadjuvant Therapy in Patients With Early-Stage Breast Cancer Using Circulating Tumor DNA Testing
Authors: Mridula George, Coral Omene, Trishala Meghal, Ekaterina Kalashnikova, Giby V. George, Philip Miller, Eshan Patel, Anya Litvak, Salma K. Jabbour, Dirk F. Moore, Deborah L. Toppmeyer, Shridar Ganesan, Angel A. Rodriguez, Minetta C. Liu
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