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In 26 women having chemotherapy before surgery for triple-negative cancer, tumour DNA in the blood fell after the first cycle in those heading for a complete response and rose again before surgery in those with cancer left behind.
Tumour and serial blood samples from 26 TNBC patients were collected before, during and after neoadjuvant chemotherapy. Individual droplet digital PCR assays were developed for 121 tumour variants (average five per patient), detecting ctDNA in 96% at baseline; baseline mutant allele frequency tracked clinical features. Levels fell sharply after one cycle, especially in eventual pCR patients, then rose significantly before surgery in patients with substantial residual tumour (P 0.0001). Detection early in treatment and at the end before surgery predicted residual tumour, though absence was less predictive of pCR when only TP53 variants were used; end-of-chemotherapy detection indicated worse relapse-free and overall survival.
Multi-variant tracking beats a TP53-only assay in TNBC and supports response-adapted designs that read ctDNA mid-chemotherapy.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Circulating tumour DNA (ctDNA), Early triple-negative breast cancer, Triple-negative breast cancer (TNBC).
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Pathologic complete response (pCR), Circulating tumour DNA (ctDNA), Early triple-negative breast cancer.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA).
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA), Triple-negative breast cancer (TNBC).
Shares Pathologic complete response (pCR), Early triple-negative breast cancer, Triple-negative breast cancer (TNBC).
Shares Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA), Triple-negative breast cancer (TNBC).
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Circulating tumour DNA (ctDNA), Early triple-negative breast cancer, Liquid biopsy (ctDNA).
Shares Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA).