Predicting Relapse in Early-Stage Breast Cancer Using ‘Liquid Biopsy’
Posted: Thursday, January 16, 2020
According to results published in JAMA Oncology, the detection of circulating tumor DNA (ctDNA) in blood samples following treatment and during follow-up appears to be linked to an increased chance for relapse in early-stage breast cancer. Nicholas C. Turner, MD, PhD, of the Institute of Cancer Research (ICR) in London, and colleagues suggest prospective studies may help to determine future uses of molecular relapse detection to improve adjuvant therapy. In addition, this blood test detected the return of disease after treatment on average 10.7 months before patients developed symptoms or secondary tumors became visible on scans.
“These new blood tests can work out which patients are at risk of relapse much more accurately than we have done before, identifying the earliest signs of relapse almost a year before the patient will clinically relapse,” said Dr. Turner, in an ICR press release.
A total of 170 women who were receiving medical treatment at 5 medical centers in the United Kingdom from November 2011 to October 2016 were enrolled in the study. Of this primary cohort, 101 women had mutations. A previous proof-of-principle study cohort of 43 patients was used for secondary analyses. For the first year of follow-up, personalized tumor-specific digital polymerase chain reaction assays tracked somatic mutations in serial plasma samples carried out every 3 months. After the first year, they were taken subsequently every 6 months.
Detection of ctDNA had a median lead time of 10.7 months after combining the cohorts and was linked with relapse in all breast cancer subtypes. In the main cohort, 14 patients relapsed, and in the second group, 15 patients relapsed. With a median follow-up of 35.5 months in the main cohort, detection of ctDNA was linked to relapse, with a hazard ratio of 25.2. “Detection of ctDNA at diagnosis, before any treatment, was also associated with relapse-free survival (hazard ratio = 5.8),” the researchers reported.
Disclosure: The study authors’ disclosure information can be found at jamanetwork.com.
