Friday the 13^th.  Yeah, I know, lots of people are superstitious.

But, not Dr. Bryan Schneider (of Indiana University, with Drs. M Raodvich, M Jiang, C Chitambar, R Nanda, C Falkson, FC Lynce, C Gallagher, C Isaacs, M. Blaya, E Paplomata, R Walling, K Daily, R Mahtani, M Thompson, R Graham, M Cooper, D Pavlick, L Albacker, J Gregg, C Bales, BA Hancock, E Cantor, F Shen, A Stomiolo, S Badve, T Ballinger, and K Miller).    Nope.  They presented their clinical trial results at the 2019 San Antonio Breast Cancer Symposium that day.  Their paper, GS5-02, Detection of circulating tumor DNA (ctDNA) after neoadjuvant chemotherapy is significantly associated with disease recurrence in early-stage triple-negative breast cancer (TNBC): Preplanned correlative results from clinical trial BRE12-158 ?  (I know, I know… That’s a mouthful.  But here’s what it really is-  a new detection technique for solid tumors- like those that obtain for breast cancer.)

The test, a liquid biopsy using FoundationOne Liquid,  involves genomic analysis of DNA that prevails in the blood plasma of patients with breast cancer.  In particular, it affords early stage detection via circulating tumor DNA (ctDNA).  This particular study examined women who might manifest triple negative breast cancer.  (This is the terminology to describe the cancer that tests negative for estrogen receptors, progesterone receptors, and excess HER2 protein).  This relatively rare cancer (some 15% of breast cancers) is associated with a much higher mortality.  The hidden problem is that these women have typically already undergone surgery and are never sure that the cancer is coming back.  Whereby the problem- that a significant proportion of these women manifest relapses- is immense.)

196 women registered in the BRE12-158 clinical trial, which began back in March 2014 (the study still has one more year to go) were the test subjects.  142 women underwent the FoundationOne Liquid test.  63% of those women manifested ctDNA (mostly TP53 mutations)- often associated with breast cancer.  Those manifesting ctDNA were linked to faster relapses (some 32 months when breast cancer reappears).  This meant they were nearly 4X as likely to die as those who were negative for ctDNA, except the results were found earlier, so there was time for treatment.

Unfortunately, additional research is still needed to make this test a normal clinical practice for breast cancer patients, as well as for patients with other solid-tumor cancers.  In particular, this test may prove most useful for those patients where tissue biopsy is not feasible.

Right now, only about 15% of all patients with advanced cancer undergo clinical genomic testing (called genomic profiling), and 60% of all cancer patients do not undergo genomic profiling.

I’m betting that is about to change… big time.

Share this: