Can Liquid Biopsy Predict Disease Relapse in Triple-Negative Breast Cancer?
Posted: Thursday, October 1, 2020
A liquid biopsy that detects circulating tumor DNA (ctDNA) and counts circulating tumor cells was predictive of disease relapse in patients with triple-negative breast cancer that did not respond to neoadjuvant therapy, according to a recent study. The combination of ctDNA and cells was 90% sensitive to detect minimal residual disease and was more predictive of disease relapse than clinical parameters such as tumor size, grade, stage, and lymph node status, according to Bryan P. Schneider, MD, of Indiana University, and colleagues, who published their findings in JAMA Oncology.
“The strength of these findings,” the authors wrote, “supports the routine use of this technology for proper risk stratification across clinical trials in the curative setting.”
The preplanned secondary analysis focused on data from 196 women in the BRE12-158 phase II clinical trial. Patients had early-stage triple-negative breast cancer with residual disease after neoadjuvant chemotherapy. The authors collected blood samples before patients began postneoadjuvant therapy. The researchers sequenced 142 patients’ ctDNA and counted circulating tumor cells for 123 patients. The median clinical follow-up was 17.2 months.
Via both ctDNA and circulating tumor cells, the sensitivity to detect minimal residual disease was 90%; ctDNA alone was 79% sensitive, and circulating tumor cells alone were 62% sensitive. As established in other studies, detection of ctDNA was associated with worse disease-free survival, distant disease–free survival, and overall survival. However, new to this study, patients who were positive for both ctDNA and circulating tumor cells had worse overall survival (hazard ratio = 8.60), worse distant disease–free survival (hazard ratio = 5.29), and worse disease-free survival (hazard ratio = 3.15) than patients who tested negative for both.
Of note, this study could not determine whether using liquid biopsy results to inform therapy can improve patient outcomes. The authors plan to test this hypothesis in the PERSEVERE trial.
Disclosure: The study authors’ disclosure information may be found at jamanetwork.com.