Integration of personalised ultrasensitive <scp>ctDNA</scp> monitoring of patients with metastatic breast cancer to reduce imaging requirements
Circulating tumour DNA (ctDNA) is an emerging biomarker for monitoring cancers. The personalised disease monitoring in metastatic breast cancer (PDM-MBC) study is an ongoing study instigated to evaluate ctDNA as a biomarker to individualise imaging requirements in patients with MBC. Patients receiving first-line endocrine therapy (aromatase inhibitor + cyclin-dependent kinase 4/6 inhibitor) had plasma samples collected pre-treatment, weeks 2 and 4, and concurrently with imaging until progressive disease (PD). Here, we apply an experimental analytical workflow for ultrasensitive ctDNA analysis, utilising personalised ctDNA panels designed from mutations identified in tumour tissue, and present results for 24 patients. Twenty patients (83%) had detectable ctDNA pre-treatment. The median progression-free survival was 25.6 months, and 13 patients experienced PD, with rising ctDNA detected at or prior to PD in 12 patients (92%). If imaging had been omitted until the detection of rising ctDNA for at least one mutation, 68% (n = 71) of the scans performed amongst ctDNA-positive patients would have been avoided. Our results demonstrate that integration of personalised ctDNA monitoring of patients with MBC has potential to substantially reduce the imaging needs in patients showing ctDNA response to treatment.
Authors
- Maria Ekholm (ORCID: https://orcid.org/0000-0002-5553-5323)
- Ellinor Elinder (ORCID: https://orcid.org/0000-0001-8596-5327)
- Karolina Larsson (ORCID: https://orcid.org/0000-0003-2347-3591)
- Anders Ståhlberg (ORCID: https://orcid.org/0000-0003-4243-0191)
- Sacha J. Howell (ORCID: https://orcid.org/0000-0001-8141-6515)
- Anne Kavanagh (ORCID: https://orcid.org/0000-0002-1573-3464)
- Monika Umińska
- Anikó Kovács (ORCID: https://orcid.org/0000-0001-7711-4418)
- Pia Mouhanna (ORCID: https://orcid.org/0009-0000-2722-2963)
- Barbro Linderholm (ORCID: https://orcid.org/0000-0003-1531-630X)
- Tobias Österlund (ORCID: https://orcid.org/0000-0002-7870-8645)
- Daniel Andersson (ORCID: https://orcid.org/0000-0002-4564-6652)
- Olle Eriksson (ORCID: https://orcid.org/0000-0002-0284-830X)
- Ahmed Albu‐Kareem
Institutions
- Linköping University (SE)
- Sahlgrenska University Hospital (SE)
- University of Manchester (GB)
- Stockholm South General Hospital (SE)
- Region Jönköpings län (SE)
- The Christie NHS Foundation Trust (GB)
- Landstinget i Kalmar län (SE)
- Ryhov Hospital Jönköping (SE)
- Linköping University Hospital (SE)
- University of Gothenburg (SE)
Publication Details
- Journal
- International Journal of Cancer
- Published
- 2024-12-18
- DOI
- https://doi.org/10.1002/ijc.35292
- Citations
- 2
- Primary Topic
- Cancer Genomics and Diagnostics
- Type
- article
- Field-Weighted Citation Impact
- 0.57
Funders
- Falk Foundation
- Forskningsrådet i Sydöstra Sverige
- Christie Charity
- Sjöbergstiftelsen
- Percy Falk Foundation
- Cancerfonden
- Gunnar Nilssons Cancerstiftelse
- Svenska Sällskapet för Medicinsk Forskning
- Vetenskapsrådet
- Svenska Läkaresällskapet
- Medical Research Council
- Futurum - Akademin för Hälsa och Vård, Region Jönköpings läns