Monitoring of circulating tumor DNA in patients with stage II-III breast cancer treated with neoadjuvant chemotherapy
Circulating tumor DNA (ctDNA) has potential as a prognostic factor for predicting relapse in high-risk breast cancer (BC). This study investigates the utility of ctDNA assessment using a tumor-informed assay, in patients with high-risk BC treated with neoadjuvant chemotherapy (NAC). Thirty newly diagnosed patients with various high-risk BC subtypes participated, providing serial blood samples at multiple time points, including baseline, during NAC, and during follow-up. ctDNA was detected at baseline in 29/29 patients for whom an assay panel could be designed, with detection sensitivity reaching 0.0083% (variant allele frequency). Among patients with detectable baseline ctDNA, 94% showed clearance during treatment, correlating with improved outcomes. Additionally, ctDNA detection post-surgery or during follow-up predicted disease recurrence. These findings suggest that serial ctDNA monitoring throughout NAC and follow-up can effectively identify residual disease in BC and correlate with clinical outcomes.
Authors
- Joshua Z. Drago (ORCID: https://orcid.org/0000-0002-7245-1172)
- H Y Kim
- Anton Safonov (ORCID: https://orcid.org/0000-0002-4100-8071)
- Sarat Chandarlapaty (ORCID: https://orcid.org/0000-0003-4532-8053)
- Enrico Moiso (ORCID: https://orcid.org/0000-0002-4405-8357)
- M Robson
- Emanuela Ferraro (ORCID: https://orcid.org/0000-0001-5863-2391)
- Tatiana Erazo (ORCID: https://orcid.org/0000-0003-2355-0999)
- Julia An (ORCID: https://orcid.org/0000-0003-2029-0335)
- George Plitas (ORCID: https://orcid.org/0000-0002-8357-9534)
- Kathleen Szuhany
- Ji‐Sun Kim (ORCID: https://orcid.org/0000-0003-4783-4654)
- Christopher Gareth Smith
- Larrw Norton
- Konner Nelson
- Amber Chevalier
- Luc Cabel
- Amy Xu
- Bob T. Li
- Atif J. Khan
- Pedram Razavi
Institutions
- Ulsan College (KR)
- Memorial Sloan Kettering Cancer Center (US)
- Seoul National University (KR)
- Asan Medical Center (KR)
- University of Ulsan (KR)
- AstraZeneca (United States) (US)
- NeoGenomics (United States) (US)
Publication Details
- Journal
- npj Breast Cancer
- Published
- 2026-01-29
- DOI
- https://doi.org/10.1038/s41523-025-00878-w
- Citations
- 1
- Primary Topic
- Cancer Genomics and Diagnostics
- Type
- article
- Field-Weighted Citation Impact
- 24.82
Funders
- Susan G. Komen for the Cure
- Memorial Sloan-Kettering Cancer Center
- National Institutes of Health
- National Cancer Institute