Liquid biopsy offers new hope for personalized breast cancer treatment
A recent study published in Clinical Cancer Research highlights a groundbreaking approach in managing advanced breast cancer: using liquid biopsy to predict patient response to targeted therapies. According to the World Health Organization, around 2.3 million women worldwide were diagnosed with breast cancer in 2022. With multiple treatment options available—including surgery, chemotherapy, radiation, immunotherapy, and targeted therapies—predicting which treatment will work for a specific patient remains a significant challenge.
Researchers analyzed blood samples from 167 patients with advanced breast cancer participating in the plasmaMATCH trial to measure circulating tumor DNA (ctDNA), tiny fragments of cancer-derived DNA circulating in the bloodstream. Patients were grouped according to breast cancer type and genetic alterations. The first group included cancers with ESR1, HER2, AKT1, AKT, or PTEN variations, while the second group consisted of triple-negative breast cancers with no targetable mutations. ctDNA levels were measured before treatment and four weeks after therapy began.
The study found a strong correlation between ctDNA levels and treatment outcomes. Patients with low or undetectable ctDNA had significantly longer progression-free survival and higher response rates. For example, in the first group, patients with undetectable ctDNA remained progression-free for an average of 10.6 months, compared to 3.5 months for those with detectable ctDNA. Similarly, 46.2% of participants with low ctDNA responded to therapy, compared with just 7.9% for those with persistently high ctDNA.
In the second group, low pre-treatment ctDNA was associated with 10.2 months of progression-free survival versus 4.4 months for those with higher levels. Participants whose ctDNA became undetectable after four weeks experienced progression-free survival of 12 months and an 85.7% response rate, compared to only 4.3 months and 11.4% for those with detectable ctDNA.
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Iseult Browne, MD, clinical research fellow at The Institute of Cancer Research, London, and first author of the study, said, “Patients with low or undetectable ctDNA consistently had better outcomes, including longer progression-free survival and higher response rates. These findings support the use of ctDNA as a non-invasive biomarker for predicting outcomes and monitoring treatment response.”
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Experts in the field see liquid biopsy as a potential game-changer for metastatic breast cancer, which is particularly difficult to treat due to its spread to other organs like bones, liver, and lungs. Richard Reitherman, MD, PhD, medical director of breast imaging at MemorialCare Breast Center, noted, “Liquid biopsy monitoring of ctDNA allows earlier identification of responders and non-responders, so treatments can be adjusted promptly.”
Similarly, Richard Zelkowitz, MD, medical director of breast oncology at Hartford HealthCare Cancer Institute, emphasized the importance of correlating early ctDNA results with patient survival. “Being able to identify patients who might not respond to a specific treatment and adjusting therapy accordingly is a game-changer for metastatic breast cancer care. This enables truly personalized treatment strategies and can significantly improve outcomes,” he said.
The study underscores the growing potential of precision medicine in oncology, offering hope to patients and clinicians seeking faster, more accurate, and less invasive ways to monitor treatment and improve survival rates.
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