New study from Indiana University: CtDNA and CTC combined to predict breast cancer recurrence more accurately.

This article is for the original translational medicine network, please indicate the source: Lauren introduction: breast cancer is often called "pink killer", and its incidence rate ranks first in the female malignant tumor.in China, the incidence rate of breast cancer is increasing year by year. More than 30 women are diagnosed with breast cancer every year.the recurrence rate of breast cancer is very high, about 30%.therefore, the detection of recurrence of breast cancer is particularly important.according to a new study, a combined method of measuring circulating tumor DNA (cfdna) and circulating tumor cells (CTC) can detect residual disease after neoadjuvant chemotherapy in patients with triple negative breast cancer (TNBC) and predict the recurrence of breast cancer.a research team led by Indiana University presented in the American Medical Association Oncology (JAMA) on July 9 This may be an important stratification tool for future post neoadjuvant therapy trials, as this molecular and cellular signal is independently associated with disease recurrence and "exceeds standard clinical parameters," a report in oncology.patients with early triple negative breast cancer often receive neoadjuvant chemotherapy because of the high risk of recurrence and death of triple negative breast cancer.some patients continued to survive without recurrence, but a considerable number of patients relapsed after chemotherapy.blood based genomic testing, or liquid biopsies, is rapidly gaining popularity among TNBC and other cancer patients to determine which patients may have residual cancer and whose prognosis may be improved by new or existing treatments.Graphic Abstract recent studies on liquid biopsy for minimal residual lesions (MRD) detection have focused on circulating tumor DNA, including previous research teams in Indiana, but the researchers of the new JAMA oncology study say that the addition of a second analyte can enhance the receipt of MRD messages because there is evidence that CTCs can be detected in some patients without ctDNA evidence number.the report of early researchers described a pre planned secondary analysis of 196 female patients in the recently completed randomized clinical trial bre12-158, which provided genomic guided neoadjuvant therapy for TNBC patients.the researchers discussed some of the findings at the San Antonio Breast Cancer Symposium last December, but share them in more detail in a new paper this week.using blood samples from patients receiving standard neoadjuvant therapy, the researchers analyzed ctDNA and counted CTC using liquid biopsy method of basic medicine and positive selection microfluidic device based on EpCAM.ctDNA was detected in 142 patients and CTCs were detected in 123 patients. The presence of ctDNA and CTCs significantly reduced the disease-free survival rate and overall survival rate.as seen in other studies, ctDNA itself is significantly associated with poor disease-free survival.the results were not statistically significant, although CTC positive patients also had poor outcomes, the researchers said.however, there was a significant correlation between the increase of CTC count and the increase of survival rate. for 112 patients with both ctDNA and CTC results, there was no significant correlation between CTC positive and ctDNA positive. in other words, in some patients, one marker is positive and the other is not. therefore, when both markers were considered, the sensitivity of MRD in the cohort was the highest: 79% for ctDNA alone, 62% for CTCs alone, and 90% for combined use. compared with double negative patients, the disease-free survival rate of ctDNA positive and CTC positive patients was significantly lower. at 24 months, the incidence of distant DFS was 52% in patients with positive biomarkers and 89% in patients with negative biomarkers. similar trends were observed in non distant DFS and overall survival. the researchers stressed that the results did not support the use of liquid biopsy MRD to guide routine clinical practice, as there was no evidence that early detection of residual disease could change treatment and improve the prognosis of patients. however, they believe that these data are sufficient to support the immediate use of their MRD strategy in clinical trials following neoadjuvant therapy, which will facilitate further collection of such evidence. this concept is at the core of the persevere trial to continue bre12-158, in which ctDNA positive TNBC patients will receive targeted agents that match their plasma ctDNA sequencing results. reference: [1] [2] recommended reading: liquid biopsy can accurately detect early renal cancer. Nature sub: liquid biopsy re flowering: urine analysis helps diagnosis of prostate cancer! Nature: new breakthrough in liquid biopsy - accurate prediction of kidney disease and cardiovascular disease risk! [science sub] breast cancer is saved! Targeted therapy works! Click to read the original