University of Leicester | April 2019 | Breast cancer relapse could be found two years earlier
Research undertaken by the University of Leicester and Imperial College London and funded by Cancer Research UK, has shown that a blood test was able to detect 89 per cent of all relapses for patients with breast cancer, with the blood test on average detecting the cancer 8.9 months quicker than imaging.
The prospective national study enrolled 49 patients with early-stage breast cancer from three NHS trusts in the UK who had recently completed treatment with surgery and adjuvant chemotherapy.
The study included a cross section of breast cancer subtypes, including HER2-positive, hormone receptor-positive, and triple-negative. Blood samples were collected every 6 months for up to 4 years from each patient, and results were correlated with radiographic and clinical outcomes.
Although this was an observational study, knowing that early detection of relapse could be possible presents the opportunity to conduct trials of treatments to prevent patients relapsing with symptomatic metastatic breast cancer (Source: University of Leicester).
Full press release from University of Leicester
The study has been published in Clinical Cancer Research
Full reference: Coombes, C. et al | 2019|Personalized detection of circulating tumor DNA antedates breast cancer metastatic recurrence |Clinical Cancer Research |10.1158/1078-0432.CCR-18-3663
Purpose: Up to 30% of breast cancer patients relapse after primary treatment. There are no sensitive and reliable tests to monitor these patients and detect distant metastases before overt recurrence. Here we demonstrate the use of personalized ctDNA profiling for detection of recurrence in breast cancer.
Methods: Forty-nine primary breast cancer patients were recruited following surgery and adjuvant therapy. Plasma samples (n=208) were collected every 6 months for up to 4 years. Personalized assays targeting 16 variants selected from primary tumor whole exome data were tested in serial plasma for the presence of ctDNA by ultra-deep sequencing (average more than100,000X).
Results: Plasma ctDNA was detected ahead of clinical or radiological relapse in 16 of the 18 relapsed patients (sensitivity of 89%); metastatic relapse was predicted with a lead time of up to 2 years (median=8.9 months; range: 0.5-24.0 months). None of the 31 non-relapsing patients were ctDNA-positive at any time point across 156 plasma samples (specificity of 100%). Of the two relapsed patients who were not detected in the study, the first had only a local recurrence, while the second patient had bone recurrence and had completed chemotherapy just 13 days prior to blood sampling.
Conclusions: This study demonstrates that patient-specific ctDNA analysis can be a sensitive and specific approach for disease surveillance for breast cancer patients. More importantly, earlier detection of up to two years provides a possible window for therapeutic intervention.
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