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Circulating tumor DNA-based predictive biomarkers in breast cancer clinical trials: a narrative review

Breast carcinoma is the most frequent and the second leading cause of cancer mortality in women worldwide. Current treatment decisions are based on tumor profiling of the initial tissue biopsy. Cancer though evolves both spatially and temporarily in a significant percentage of patients during treatm...

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Autores principales: Fiste, Oraianthi, Liontos, Michael, Koutsoukos, Konstantinos, Terpos, Evangelos, Dimopoulos, Meletios A., Zagouri, Flora
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791253/
https://www.ncbi.nlm.nih.gov/pubmed/33437802
http://dx.doi.org/10.21037/atm-20-1175
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author Fiste, Oraianthi
Liontos, Michael
Koutsoukos, Konstantinos
Terpos, Evangelos
Dimopoulos, Meletios A.
Zagouri, Flora
author_facet Fiste, Oraianthi
Liontos, Michael
Koutsoukos, Konstantinos
Terpos, Evangelos
Dimopoulos, Meletios A.
Zagouri, Flora
author_sort Fiste, Oraianthi
collection PubMed
description Breast carcinoma is the most frequent and the second leading cause of cancer mortality in women worldwide. Current treatment decisions are based on tumor profiling of the initial tissue biopsy. Cancer though evolves both spatially and temporarily in a significant percentage of patients during treatment. However, sequential biopsies from the primary tumor or its metastatic sites are not either convenient or feasible in the majority of cases. In the era of precision medicine, analysis of circulating blood-based biomarkers in the field of liquid biopsies provides an insight into the dynamic molecular profiling of the primary tumor and its metastases, in a relatively non-invasive way. The latter permits not only patient stratification but also longitudinal evaluation of treatment response, when incorporated into clinical trials. This review summarizes the results from recent and ongoing circulating tumor DNA (ctDNA)-based biomarker-driven clinical trials, with respect to ctDNA analysis’ predictive role, both in adjuvant, neo-adjuvant, and metastatic setting. Furthermore, current challenges in ctDNA analysis applications are critically discussed, including pre-analytical and analytical issues, and future perspectives in this field, through the conduct of well-designed, multicenter, randomized, large-scale, biomarker-stratified trials, with robust statistical methods. Despite in its infancy, ctDNA analysis holds great promise as a minimally invasive tool regarding tailored, personalized treatment guidance for breast cancer patients.
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spelling pubmed-77912532021-01-11 Circulating tumor DNA-based predictive biomarkers in breast cancer clinical trials: a narrative review Fiste, Oraianthi Liontos, Michael Koutsoukos, Konstantinos Terpos, Evangelos Dimopoulos, Meletios A. Zagouri, Flora Ann Transl Med Review Article Breast carcinoma is the most frequent and the second leading cause of cancer mortality in women worldwide. Current treatment decisions are based on tumor profiling of the initial tissue biopsy. Cancer though evolves both spatially and temporarily in a significant percentage of patients during treatment. However, sequential biopsies from the primary tumor or its metastatic sites are not either convenient or feasible in the majority of cases. In the era of precision medicine, analysis of circulating blood-based biomarkers in the field of liquid biopsies provides an insight into the dynamic molecular profiling of the primary tumor and its metastases, in a relatively non-invasive way. The latter permits not only patient stratification but also longitudinal evaluation of treatment response, when incorporated into clinical trials. This review summarizes the results from recent and ongoing circulating tumor DNA (ctDNA)-based biomarker-driven clinical trials, with respect to ctDNA analysis’ predictive role, both in adjuvant, neo-adjuvant, and metastatic setting. Furthermore, current challenges in ctDNA analysis applications are critically discussed, including pre-analytical and analytical issues, and future perspectives in this field, through the conduct of well-designed, multicenter, randomized, large-scale, biomarker-stratified trials, with robust statistical methods. Despite in its infancy, ctDNA analysis holds great promise as a minimally invasive tool regarding tailored, personalized treatment guidance for breast cancer patients. AME Publishing Company 2020-12 /pmc/articles/PMC7791253/ /pubmed/33437802 http://dx.doi.org/10.21037/atm-20-1175 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article
Fiste, Oraianthi
Liontos, Michael
Koutsoukos, Konstantinos
Terpos, Evangelos
Dimopoulos, Meletios A.
Zagouri, Flora
Circulating tumor DNA-based predictive biomarkers in breast cancer clinical trials: a narrative review
title Circulating tumor DNA-based predictive biomarkers in breast cancer clinical trials: a narrative review
title_full Circulating tumor DNA-based predictive biomarkers in breast cancer clinical trials: a narrative review
title_fullStr Circulating tumor DNA-based predictive biomarkers in breast cancer clinical trials: a narrative review
title_full_unstemmed Circulating tumor DNA-based predictive biomarkers in breast cancer clinical trials: a narrative review
title_short Circulating tumor DNA-based predictive biomarkers in breast cancer clinical trials: a narrative review
title_sort circulating tumor dna-based predictive biomarkers in breast cancer clinical trials: a narrative review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791253/
https://www.ncbi.nlm.nih.gov/pubmed/33437802
http://dx.doi.org/10.21037/atm-20-1175
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