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In 196 women with triple-negative breast cancer left with residual tumour after pre-surgery chemotherapy, finding tumour DNA in the blood after surgery tripled the risk of distant relapse and quadrupled the risk of death; at two years 56 percent versus 81 percent were free of distant disease.
Radovich, Jiang, Hancock, Chitambar and colleagues report a preplanned secondary analysis of BRE12-158, a phase 2 trial that randomised patients with early-stage triple-negative breast cancer and residual disease after neoadjuvant chemotherapy to genomically directed therapy or physician's choice; 196 patients had blood drawn at treatment assignment, with ctDNA (FoundationACT or FoundationOne Liquid) analysed for survival in 142 and circulating tumour cells in 123, median follow-up 17.2 months. ctDNA detection was associated with inferior distant disease-free survival (median 32.5 months versus not reached; hazard ratio 2.99, 95 percent confidence interval 1.38 to 6.48, p=0.006; two-year probability 56 versus 81 percent), disease-free survival (2.67) and overall survival (4.16, 1.66 to 10.42, p=0.002). Patients positive for both ctDNA and circulating tumour cells had a distant disease-free survival hazard ratio of 5.29 versus double-negative patients (two-year probability 52 versus 89 percent) and overall survival hazard ratio 8.60.
The proof that a blood test can split residual-disease patients into those likely to relapse and those likely cured, the premise of the ctDNA-guided adjuvant idea; no completed trial has yet acted on the result.
Shares ctDNA-guided adjuvant decisions after residual disease: escalate the positive, spare the negative, Residual cancer burden (RCB), Hazard ratio (HR), Dormant cells and minimal residual disease and the tag tnbc-evidence.
Shares ctDNA-guided adjuvant decisions after residual disease: escalate the positive, spare the negative, Residual cancer burden (RCB), Hazard ratio (HR), Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem and the tag tnbc-evidence.
Shares Hazard ratio (HR), Biomarkers are not validated or standardised, Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares ctDNA-guided adjuvant decisions after residual disease: escalate the positive, spare the negative, Residual cancer burden (RCB), Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Hazard ratio (HR), Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Biomarkers are not validated or standardised, Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Residual cancer burden (RCB), Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Hazard ratio (HR), Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.