Aydah AlAwadhi, Consultant Medical Oncologist and Division Chair of Hematology and Oncology Department at Sheikh Shakbout Medical City, Abu Dhabi, shared a post on LinkedIn:
“The Future of Early Breast Cancer May Be Written in ctDNA, Not Just the Pathology Report.
A significant study published in the Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO) highlights the role of ultrasensitive ctDNA and minimal residual disease in early breast cancer.
Key findings from the PREDICT-DNA trial (NeXT Personal) include:
- ctDNA-negative non-pCR patients showed outcomes comparable to pCR patients.
- Detectable ctDNA after neoadjuvant therapy increased the recurrence risk by approximately 9-fold (HR ≈ 8.9).
- ctDNA predicted outcomes independently of pCR.
- ctDNA-negative patients experienced excellent outcomes, while ctDNA-positive patients represented a very high-risk group.
Though the sample size is small, the findings are impactful.
This research suggests a potential transition from evaluating pCR versus non-pCR to assessing molecular residual disease versus no molecular residual disease. This shift could influence: Escalation and De-escalation strategies treatment decision.
My takeaways:
- We may be moving from pCR vs. non-pCR to MRD vs no MRD.
- These findings may not apply to all breast cancer subtypes, but mainly HER2-positive and TNBC.
- It would be very interesting to explore correlations with MDA RCB regression scoring.
- Long-term recurrence outcomes are still needed.
- Most importantly, we need predictive studies showing that ctDNA-guided treatment decisions can actually improve outcomes, not just prognosticate.”
Title: The Pathologic Response Evaluation and Detection in Circulating Tumor-DNA Study: Ultrasensitive Circulating Tumor-DNA Assessment of Breast Cancer Minimal Residual Disease
Authors: Natasha B. Hunter, Heather A. Parsons, Leslie Cope, Jenna V. Canzoniero, Fabio C.P. Navarro, Sherif El-Refai, Jesus D. Anampa, Joseph A. Sparano, Mothaffar Rimawi, Anna Maria Storniolo, Candace Mainor, Rita Nanda, Angela DeMichele, Gaorav P. Gupta, Erica J. Stringer-Reasor, Filipa Lynce, Erin F. Cobain, Shannon Puhalla, Rachel Jankowitz, Brent Rexer, Ingrid Mayer, E. Shelley Hwang, Kimberly Blackwell, Walid El Ayass, Young Lee, Carol Tweed, Mary Wilkinson, Angela Pennisi, Bonnie Sun, Pamela Wright, Julie R. Gralow, Richard Chen, Sean M. Boyle, Vered Stearns, Antonio C. Wolff and Ben Ho Park.
Other articles featuring Aydah AlAwadhi on OncoDaily.
