Biomarkers of residual disease detected in the blood at surgery following neoadjuvant chemotherapy can identify which patients with triple-negative breast cancer will have a better outcome at 2 years and which will do much worse, a phase 2 randomized controlled trial indicates.
“What we know with triple-negative breast cancer is that these cancers tend to recur at a very high rate, particularly peaking in the first 3 years after surgery, and this causes an untenable situation for our patients, who live in constant fear and uncertainty of their cancer recurring after chemotherapy and surgery,” Milan Radovich, PhD, associate professor of surgery and medical and molecular genetics, Indiana University School of Medicine in Indianapolis, said at a press briefing at the San Antonio Breast Cancer Symposium (SABCS) 2019.
“We found that the detection of circulating tumor DNA (ctDNA) as well as circulating tumor cells (CTCs) in early-stage, triple-negative breast cancer after neoadjuvant chemotherapy is an independent predictor of disease recurrence and represents, we think, an important, novel stratification factor for post-neoadjuvant trials,” he added.
The BRE12-158 trial involved 151 patients with early-stage, triple-negative breast cancer in whom there was evidence of residual disease at surgery following neoadjuvant chemotherapy.
“The first marker we focused on was a marker called ctDNA,” Radovich noted. As he explained, ctDNA is DNA that is shed from tumors into the circulation, where next-generation sequencing techniques can be used to noninvasively detect the DNA in a simple blood draw.