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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.
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%).
For TNBC, where brain metastases are common, the blind spot matters: a negative ctDNA test does not exclude intracranial relapse.
Shares Nicholas Turner, ctDNA MRD positivity (molecular residual disease after curative treatment), The Institute of Cancer Research, The Royal Marsden.
Shares Nicholas Turner, ctDNA MRD positivity (molecular residual disease after curative treatment), The Institute of Cancer Research, The Royal Marsden.
Shares JAMA Oncology, Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), JAMA Oncology, Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA).
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Circulating tumour DNA (ctDNA), Triple-negative breast cancer (TNBC).