ctDNA Detection After Neoadjuvant Therapy Strongly Predicts Recurrence Risk in Early-Stage Triple-Negative Breast Cancer
Key Clinical Takeaways
- Postoperative ctDNA positivity was a powerful predictor of distant recurrence in early TNBC, with MRD+ patients experiencing a markedly increased risk compared with ctDNA-negative patients (HR, 30.3)
- ctDNA was detectable in nearly all patients at baseline and showed substantial clearance during neoadjuvant therapy, highlighting its utility for monitoring molecular response.
- The bespoke multi-variant ctDNA assay demonstrated strong feasibility and sensitivity, supporting its potential role in refining post-neoadjuvant risk stratification and guiding treatment decisions in TNBC.
Marija Balic, MD, PhD, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, discusses results from the NSABP B-59/GBG-96-GeparDouze circulating tumor DNA (ctDNA) sub-study evaluating whether molecular residual disease (MRD) detected by ctDNA can predict recurrence risk after neoadjuvant therapy and surgery among patients with early-stage triple-negative breast cancer.
Serial bespoke ctDNA assays revealed that postoperative ctDNA positivity was strongly prognostic for distant recurrence, with a markedly elevated hazard ratio and consistent findings across recurrence end points.
These findings were presented at the 2025 San Antonio Breast Cancer Symposium in San Antonio, Texas.
Source:
Balic M, Tang G, Young G, et al. Evaluation of a whole-exome sequencing tumor-informed circulating tumor DNA MRD assay in patients with early triple-negative breast cancer (TNBC) receiving neoadjuvant chemotherapy (NAC) with or without atezolizumab: A prospective sub study of the NSABP-B59/GBG-96-GeparDouze trial. Presented at SABCS 2025. December 9 - 12, 2025. San Antonio, Texas. Abstract RF4-03
