# ctDNA and residual cancer burden are prognostic in triple-negative breast cancer patients with residual disease

Source: https://onco.cc/key-papers/paper-stecklein-ctdna-rcb-tnbc-residual-disease-npj-2023/  
OnCo record `paper-stecklein-ctdna-rcb-tnbc-residual-disease-npj-2023` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Among 80 women with triple-negative cancer left at surgery after chemotherapy, a third had ctDNA in their blood; their three-year event-free survival was 48% against 82%, and the blood test added to the pathologist's residual cancer burden score.

## Summary

End-of-treatment ctDNA was analysed in 80 TNBC patients with residual disease after neoadjuvant systemic therapy in a prospective multisite registry. 33% were ctDNA-positive; residual cancer burden was RCB-I 26%, RCB-II 49%, RCB-III 18%. ctDNA positivity rose with RCB class (14%, 31%, 57%; P 0.028) and was associated with inferior three-year event-free survival (48% versus 82%) and overall survival (50% versus 86%), including within RCB-II (65% versus 87%). RCB class (HR 5.16) and ctDNA status (HR 3.71) were independently prognostic after adjusting for T stage and nodes.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: npj Breast Cancer
- Year: 2023
- DOI: 10.1038/s41523-023-00512-7
- Authors: Stecklein SR, Kimler BF, Yoder R, et al.
- Findings: ctDNA positive in 33%; 14%, 31% and 57% of RCB-I, II and III.; Three-year EFS 48% versus 82%; OS 50% versus 86%.; RCB (HR 5.16) and ctDNA (HR 3.71) independently prognostic.
- What it means: ctDNA and RCB measure different things and both should stratify post-neoadjuvant TNBC trials; an RCB-II patient with negative ctDNA has an 87% three-year event-free survival.
- Caveats: 80 patients; registry rather than trial.; Assay details and lead times are not in the abstract.

## Sources

- Stecklein et al., npj Breast Cancer 2023: ctDNA and residual cancer burden in 80 TNBC patients with residual disease: https://doi.org/10.1038/s41523-023-00512-7
- PubMed: https://pubmed.ncbi.nlm.nih.gov/36878909/

## Connected records

- biomarkers: [ctDNA MRD positivity (molecular residual disease after curative treatment)](https://onco.cc/biomarkers/ctdna-mrd-positive/)
- cancers: [Early triple-negative breast cancer](https://onco.cc/cancers/tnbc-early/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- technologies: [MRD / molecular residual disease testing](https://onco.cc/technologies/mrd-testing/)
- terms: [Circulating tumour DNA (ctDNA)](https://onco.cc/terms/ctdna/), [Minimal / molecular residual disease (MRD)](https://onco.cc/terms/mrd/), [Residual cancer burden (RCB)](https://onco.cc/terms/rcb/)
- people: [Priyanka Sharma](https://onco.cc/people/priyanka-sharma/)

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