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Recent headlines announced a blood test that can potentially predict which breast cancer survivors are at risk of recurrence. This particular blood test, one of many being developed, is sometimes called a “liquid biopsy.” This early research focuses on a technique that is promising, but not yet available to breast cancer survivors. (10/12/15)
Early research on a new blood test, sometimes called a liquid biopsy, that may help identify patients who are at risk of breast cancer recurrence.
With an effective method of identifying patients who are at risk of recurrence, clinical trials of therapies aimed to prevent relapse could be targeted towards these patients.
This small study is still early in the development process. While results are promising, more work is needed before this test can be used to identify patients who are at risk of recurrence.
Medical News Today
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About 95% of women diagnosed with breast cancer have early-stage breast cancer with no evidence of metastasis. However, some of these women have micrometastatic disease, a form of metastasis in which breast cancer cells have spread, but newly formed tumors are too small to be detected by current imaging and testing technologies. Treatment and surgery do not always eliminate these micrometastatic lesions, and currently, we are unable to determine which patients still have micrometastatic disease (also called minimal residual disease-MRD) and which do not. Circulating tumor DNA (ctDNA) is released into the blood by dying tumor cells. ctDNA are small pieces of tumor DNA that characterize the genetic features of tumors in patients with advanced cancer. However, little data is available regarding detection of ctDNA in early-stage breast cancers to predict if they are likely to recur.
Whether looking for circulating tumor DNA (ctDNA) in the blood can identify patients with micrometastatic disease.
The study followed 55 early-stage breast cancer patients for about 2 years.
While results from this study population are promising, the sample size of 55 patients is relatively small. Because the study only looked at patients who had surgery and chemotherapy, whether these findings apply to patients who have surgery only (without adjuvant chemotherapy), or to patients who have surgery followed by adjuvant chemotherapy is unknown. Additionally, the follow-up period was short—about 2 years for most patients—so whether other patients recurred after the follow-up period is also unknown.
In this study, ctDNA was found a median of 7.9 months before the patient’s recurrence was detected in a clinic, indicating that identification of circulating tumor DNA (ctDNA) may be a potentially useful blood test to predict cancer relapse. The blood test could help physicians identify patients for clinical trials to prevent relapse, because ctDNA would be identified several months before a relapse could be detected clinically. However, because of the limited sample size and specified treatments of the study population, it is unclear whether or not these results will apply to everyone with breast cancer. But it is very promising, and more work should be done to pursue ctDNA and other liquid biopsy tests to detect cancer recurrence.
Garcia-Murillas I, Schiavon G, Weigelt B, et al. “Mutation tracking in circulating tumor DNA predicts relapse in early breast cancer.” Science Translational Medicine, Vol. 7, No. 302, Aug. 26, 2015.