https://doi.org/10.55788/c7c2526b
Patients with node-positive early breast cancer are at high risk of recurrence (up to 30% at 5 years) [1]. The monarchE trial (NCT03155997) showed a sustained benefit of 2 years of adjuvant abemaciclib to endocrine therapy in patients with HR-positive/HER2-negative, node-positive, high-risk early breast cancer: 7.6% and 6.7% absolute improvement in invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS), respectively [2].
To evaluate the prognostic value of ctDNA detection and its dynamics, Prof. Sherene Loi (Peter MacCallum Cancer Centre, Australia) and colleagues analysed a representative subset of participants from the monarchE trial [3].
Of the 5,637 participants enrolled in monarchE, ctDNA was obtained from 910 participants at baseline; ≥1 post-baseline sample was obtained from 889 participants. A consistent treatment effect was observed in the total population and the subpopulation with ctDNA samples (IDFS HR 0.68 and 0.67, respectively).
The ctDNA detection rate at baseline was 8% (n=70). Among participants who were ctDNA-negative at baseline (n=840), 10% became positive on treatment. Among participants who were ctDNA-positive at baseline (n=92), 59% remained positive on treatment.
Baseline ctDNA detection proved to be associated with worse invasive disease-free survival (IDFS) outcomes: the 4-year IDFS rate was 79.1% in baseline ctDNA-negative participants versus 20.0% in baseline ctDNA-positive participants (P<0.0001). Participants who remained ctDNA-positive or became ctDNA-positive on treatment were more likely to experience an IDFS event than those who became ctDNA-negative or remained ctDNA-negative (see Figure).
Figure: ctDNA status associated with treatment outcomes in monarchE [3]
In addition, more distant recurrence was observed in participants who were ctDNA-positive at baseline than in those who were ctDNA-negative.
Based on these outcomes, Prof. Loi concluded that “ctDNA detection was highly prognostic of worse treatment outcomes, particularly in patients who were persistently ctDNA-positive. Further intensification of treatment with novel therapeutics should be considered for these patients.”
- Sheffield KM et al. Future Oncol. 2022;18:2667-2682.
- Rastogi P, et al. J Clin Oncol. 2024;42:987-993.
- Loi S, et al. Prognostic utility of ctDNA detection in the monarchE trial of adjuvant abemaciclib plus endocrine therapy (ET) in HR+, HER2-, node-positive, high-risk early breast cancer (EBC). Abstract LBA507, ASCO Annual Meeting 2024, 31 May–4 June, Chicago, IL, USA.
Copyright ©2024 Medicom Medical Publishers
Posted on
Previous Article
« Adjuvant avelumab significantly improves survival in early TNBC Next Article
Benefit of abemaciclib plus fulvestrant after progression on a CDK4/6 inhibitor »
« Adjuvant avelumab significantly improves survival in early TNBC Next Article
Benefit of abemaciclib plus fulvestrant after progression on a CDK4/6 inhibitor »
Table of Contents: ASCO 2024
Featured articles
Meet the Trialist: Prof. Giuseppe Curigliano on DESTINY-Breast06
Gastrointestinal: Colorectal Cancer
No survival benefit of tumour debulking for patients with multi-organ metastatic CRC
Thermal ablation of small-size colorectal liver metastases is non-inferior to resection
Benefit of first-line nivolumab/ipilimumab in MSI-H/dMMR metastatic CRC
CodeBreaK 300: Promising survival trends in KRAS G12C-mutated mCRC
Gastrointestinal: Upper GI Cancer
FLOT outperforms CROSS in resectable oesophageal cancer
Nivolumab/ipilimumab combination outperforms TKIs in unresectable HCC
No advantage of neoadjuvant radiochemotherapy over neoadjuvant chemotherapy in borderline resectable pancreatic cancer
Breast Cancer
Benefit of abemaciclib plus fulvestrant after progression on a CDK4/6 inhibitor
ctDNA is prognostic of worse outcomes for CDK4/6 therapy
Adjuvant avelumab significantly improves survival in early TNBC
High pCR rate after neoadjuvant Dato-DXd plus durvalumab therapy
Lung Cancer
Osimertinib significantly improves PFS in patients with unresectable stage III EGFR-mutated NSCLC
First-line lorlatinib provides unprecedented improvement for patients with advanced ALK-positive NSCLC
Comparable benefit of video- and in-person-delivered palliative care
Consolidation with durvalumab improves survival in LS-SCLC
Subcutaneous amivantamab non-inferior and more convenient than intravenous amivantamab
Melanoma
Highly significant event-free survival benefit with neoadjuvant nivolumab/ipilimumab in stage III melanoma
Neoadjuvant intralesional daromun improves relapse-free survival in stage III melanoma
Intratumoural tilsotolimod shows no benefit for advanced refractory melanoma
Genitourinary Cancer
Immune-enhancing nutrition does not affect complication rate of radical cystectomy
ctDNA changes as biomarker for pembrolizumab response in advanced urothelial carcinoma
Highest efficacy of nivolumab/chemotherapy in lymph-node-only metastatic urothelial carcinoma
Genitourinary: Prostate Cancer
Metformin does not prevent progression of low-risk prostate cancer
Baseline ctDNA has both prognostic and predictive value in mCRPC
Oxybutynin significantly decreases frequency and severity of hot flashes in men on ADT
Gynaecological Cancer
Batiraxcept shows promise in high AXL-expressing, platinum-resistant ovarian cancer
No lymphadenectomy for advanced ovarian cancer without suspicious nodes
SIENDO: Efficacy benefit of selinexor in TP53 wildtype endometrial cancer
Novel regimen for HR-positive endometrial cancer on the way?
Related Articles
August 12, 2021
Novel drug combination for recurrent ovarian cancer
December 18, 2023
Top 10 medical breakthroughs in 2023
© 2024 Medicom Medical Publishers. All rights reserved. Terms and Conditions | Privacy Policy
HEAD OFFICE
Laarderhoogtweg 25
1101 EB Amsterdam
The Netherlands
T: +31 85 4012 560
E: publishers@medicom-publishers.com