{"entity":{"id":"paper-garcia-murillas-molecular-relapse-detection-jama-oncol-2019","kind":"paper","name":"Assessment of molecular relapse detection in early-stage breast cancer","aka":[],"tldr":"In 101 women followed with blood tests every few months after treatment for early breast cancer, ctDNA appeared a median of 10.7 months before relapse showed on scans and caught 22 of 23 distant relapses outside the brain but only one of six brain-only relapses.","summary":"Prospective multicentre validation study at five UK centres (2011 to 2016) of women with early breast cancer of any subtype receiving neoadjuvant or adjuvant chemotherapy; 170 recruited, 101 with mutations identified formed the main cohort, and 144 the combined cohort. Personalised digital PCR assays tracked primary tumour mutations in plasma every three months for a year and six-monthly thereafter. ctDNA detection during follow-up was associated with relapse (HR 25.2; P less than .001), as was detection at diagnosis (HR 5.8). Median lead time was 10.7 months; distant extracranial relapse was detected by ctDNA in 22 of 23 (96%) but brain-only metastasis in 1 of 6 (17%).","asOf":"2026-09-24","links":[{"label":"Garcia-Murillas et al., JAMA Oncol 2019: molecular relapse detection in 101 early breast cancer patients","url":"https://doi.org/10.1001/jamaoncol.2019.1838"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/31369045/"}],"tags":[],"related":["ctdna-mrd-positive"],"cancers":["tnbc","breast-cancer"],"sections":[],"technologies":["mrd-testing"],"targets":[],"drugs":[],"companies":[],"institutions":["icr-london","royal-marsden"],"pathways":[],"terms":["ctdna","mrd"],"trials":[],"people":["nicholas-turner"],"bottlenecks":[],"keyPapers":[],"journals":["jama-oncology"],"dependsOn":[],"notes":[],"journal":"JAMA Oncology","year":2019,"doi":"10.1001/jamaoncol.2019.1838","pmid":"31369045","authors":"Garcia-Murillas I, Chopra N, Comino-Mendez I, et al.","paperType":"observational","findings":["ctDNA during follow-up: relapse HR 25.2; at diagnosis HR 5.8.","Median lead time 10.7 months; extracranial relapse detected in 96%, brain-only in 17%."],"whatItMeans":"For TNBC, where brain metastases are common, the blind spot matters: a negative ctDNA test does not exclude intracranial relapse.","caveats":["All subtypes; TNBC-specific numbers are not in the abstract.","Digital PCR assays of a few variants."],"changedPractice":false,"participants":101},"route":"/key-papers/paper-garcia-murillas-molecular-relapse-detection-jama-oncol-2019/","neighbours":{"biomarker":[{"id":"ctdna-mrd-positive","kind":"biomarker","name":"ctDNA MRD positivity (molecular residual disease after curative treatment)","route":"/biomarkers/ctdna-mrd-positive/"}],"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"mrd-testing","kind":"technology","name":"MRD / molecular residual disease testing","route":"/technologies/mrd-testing/"}],"institution":[{"id":"icr-london","kind":"institution","name":"The Institute of Cancer Research","route":"/institutions/icr-london/"},{"id":"royal-marsden","kind":"institution","name":"The Royal Marsden","route":"/institutions/royal-marsden/"}],"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/"}],"person":[{"id":"nicholas-turner","kind":"person","name":"Nicholas Turner","route":"/people/nicholas-turner/"}],"journal":[{"id":"jama-oncology","kind":"journal","name":"JAMA Oncology","route":"/journals/jama-oncology/"}]}}