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Using ctDNA to Predict Recurrence of Triple-Negative Breast Cancer

By: Dana A. Elya, MS, RD, CDN
Posted: Monday, January 6, 2020

The detection of circulating tumor DNA (ctDNA) in early-stage triple-negative breast cancer after neoadjuvant chemotherapy was identified as an independent predictor of disease recurrence. These findings, from the recently completed phase II BRE12-158 clinical trial, were presented at the 2019 San Antonio Breast Cancer Symposium (Abstract GS5-02). Milan Radovich, PhD, of the Indiana University Simon Cancer Center, Indianapolis, and colleagues noted that the study’s findings represent a novel stratification for clinical studies evaluating the ability to reduce postsurgical treatment time for these patients.

“ctDNA is a powerful tool to be able to predict recurrence and could help us identify the best ways to manage care for women diagnosed with this disease,” shared Dr. Radovich in an American Association for Cancer Research press release.

Researchers sequenced ctDNA from 150 patients, and of this group, 148 underwent clinical follow-up. Mutated ctDNA was found in 94 of 148 sequenced patients (64%). The most commonly mutated gene with prior genomic studies of triple-negative breast cancer was TP53.

Follow-up at 16.7 months showed ctDNA was significantly associated with an inferior distant disease–free survival. At 24 months, the probability of distant disease–free survival was 53% in patients with positive ctDNA versus 81% in ctDNA-negative patients. In multivariate analysis, when the investigators considered significant covariates, ctDNA remained independently associated with inferior distant disease–free survival (hazard ratio = 3.1; 95% confidence interval = 1.4–6.8; P = .0048). Detection of ctDNA was associated with inferior overall survival in univariate and multivariate analysis.

A clinical trial is expected to launch in 2020 to further examine ctDNA’s potential to guide therapy for those patients at high risk for breast cancer recurrence.

Disclosure: The study authors’ disclosure information can be found at abstractsonline.com.



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