Advancements in ctDNA Testing for Early Detection of Breast Cancer Recurrence

ctDNA Testing for Early Detection:

Recent studies have shown that ctDNA testing can predict breast cancer recurrence months or even years before clinical relapse in high-risk patients23.
The use of whole genome sequencing (WGS) in liquid biopsies allows for the detection of up to 1,800 mutations, making it more sensitive than traditional whole exome sequencing (WES) methods23.

Association with Disease Recurrence:

ctDNA positivity has been associated with disease recurrence in patients with hormone receptor-positive, HER2-negative, node-positive, high-risk early breast cancer1.
The detection of ctDNA at any point after surgery or during follow-up was linked to a high risk of future relapse and poorer overall survival23.

Potential for Early Intervention:

Early detection of molecular residual disease through ctDNA testing could enable early intervention, potentially preventing or delaying metastatic recurrence234.
Ongoing trials, such as the TRAK-ER trial, are exploring whether altering treatment based on ctDNA positivity can prevent relapse in patients with residual disease23.

Technical Feasibility:

The Signatera assay has demonstrated technical feasibility in detecting ctDNA in patients with early breast cancer, showing that ctDNA positivity is associated with disease recurrence1.
The RaDaR assay has also shown sensitivity in detecting ctDNA at baseline and during neoadjuvant therapy, indicating its potential for early detection of recurrence4.

Future Directions:

Further research and testing are needed to determine whether detecting molecular residual disease can guide therapy in the future23.
The development of more sensitive tests and the integration of ctDNA monitoring into clinical practice could significantly improve post-treatment monitoring and potentially extend patient survival23.

Sources:

1. https://www.targetedonc.com/view/ctdna-may-identify-risk-of-recurrence-in-early-breast-cancer-subgroup

2. https://ascopost.com/news/june-2024/novel-ctdna-liquid-biopsy-may-help-predict-breast-cancer-recurrence-years-before-relapse/

3. https://medicalxpress.com/news/2024-06-ultra-sensitive-blood-recurrence-breast.html

4. https://www.sabcsmeetingnews.org/poster-spotlight-session-6-prognostic-and-predictive-uses-of-cell-free-dna-presenter-profiles/