{"entity":{"id":"paper-ctrak-tn-tissue-free-mrd-jamaoncol-2026","kind":"paper","name":"c-TRAK TN analysis: tissue-free versus tumour-informed ctDNA assays for residual disease in early triple-negative breast cancer","aka":[],"tldr":"A blood test that needs no tumour sample found leftover cancer DNA in a third of women after treatment for triple-negative breast cancer, and those women were far more likely to relapse; it agreed closely with the tests that first sequence the tumour.","summary":"Prognostic and exploratory analysis of the ctDNA surveillance period of c-TRAK TN, a multicentre phase 2 study in triple-negative breast cancer at moderate to high risk of recurrence. Plasma was collected every three months for up to two years after adjuvant therapy. A tissue-free methylation assay was compared with digital PCR and whole-exome-powered tumour-informed assays across 1,026 samples from 159 patients.","asOf":"2026-09-21","links":[{"label":"JAMA Oncology 2026","url":"https://doi.org/10.1001/jamaoncol.2026.2833"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/42593771/"}],"tags":[],"related":[],"cancers":["tnbc"],"sections":[],"technologies":["liquid-biopsy","mrd-testing"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["tumour-informed-assay","mrd","ctdna"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jama-oncology"],"dependsOn":[],"notes":[],"journal":"JAMA Oncology","year":2026,"doi":"10.1001/jamaoncol.2026.2833","pmid":"42593771","authors":"Cunningham N, Cutts RJ, Swift C, et al.","paperType":"translational","findings":["The tissue-free assay detected ctDNA in 54 of 159 patients (34 percent).","Detection was strongly associated with recurrence: hazard ratio 27.2 (95 percent CI 13.7 to 54.2) for recurrence-free survival."],"whatItMeans":"Residual-disease testing may not need the tumour to be sequenced first, which would remove the slowest step of tumour-informed assays; the comparison with tumour-informed results in the same patients is the evidence that matters.","caveats":["Exploratory analysis of a phase 2 study, not a randomised comparison of assays.","Single cancer type and a moderate to high-risk population; performance in other settings is untested.","Follow-up through January 2023 with analysis in 2025 to 2026."],"changedPractice":false,"participants":159},"route":"/key-papers/paper-ctrak-tn-tissue-free-mrd-jamaoncol-2026/","neighbours":{"cancer":[{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"mrd-testing","kind":"technology","name":"MRD / molecular residual disease testing","route":"/technologies/mrd-testing/"}],"term":[{"id":"ctdna","kind":"term","name":"Circulating tumour DNA (ctDNA)","route":"/terms/ctdna/"},{"id":"mrd","kind":"term","name":"Minimal / molecular residual disease (MRD)","route":"/terms/mrd/"},{"id":"tumour-informed-assay","kind":"term","name":"Tumour-informed versus tumour-naive ctDNA assays","route":"/terms/tumour-informed-assay/"}],"journal":[{"id":"jama-oncology","kind":"journal","name":"JAMA Oncology","route":"/journals/jama-oncology/"}]}}