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Circulating tumor DNA profiling from breast cancer screening through to metastatic disease

Title: Circulating tumor DNA profiling from breast cancer screening through to metastatic disease
Authors: Page, K
Martinson, LJ
Fernandez-Garcia, D
Hills, A
Gleason, KLT
Gray, MC
Rushton, AJ
Nteliopoulos, G
Hastings, RK
Goddard, K
Ions, C
Parmar, V
Primrose, L
Openshaw, MR
Guttery, DS
Palmieri, C
Ali, S
Stebbing, J
Coombes, RC
Shaw, JA
Item Type: Journal Article
Abstract: PURPOSE: We investigated the utility of the Oncomine Breast cfDNA Assay for detecting circulating tumor DNA (ctDNA) in women from a breast screening population, including healthy women with no abnormality detected by mammogram, and women on follow-up through to advanced breast cancer. MATERIALS AND METHODS: Blood samples were taken from 373 women (127 healthy controls recruited through breast screening, 28 ductal carcinoma in situ, 60 primary breast cancers, 47 primary breast cancer on follow-up, and 111 metastatic breast cancers [MBC]) to recover plasma and germline DNA for analysis with the Oncomine Breast cfDNA Assay on the Ion S5 platform. RESULTS: One hundred sixteen of 373 plasma samples had one or more somatic variants detected across eight of the 10 genes and were called ctDNA-positive; MBC had the highest proportion of ctDNA-positive samples (61; 55%) and healthy controls the lowest (20; 15.7%). ESR1, TP53, and PIK3CA mutations account for 93% of all variants detected and predict poor overall survival in MBC (hazard ratio = 3.461; 95% CI, 1.866 to 6.42; P = .001). Patients with MBC had higher plasma cell-free DNA levels, higher variant allele frequencies, and more polyclonal variants, notably in ESR1 than in all other groups. Only 15 individuals had evidence of potential clonal hematopoiesis of indeterminate potential mutations. CONCLUSION: We were able detect ctDNA across the breast cancer spectrum, notably in MBC where variants in ESR1, TP53, and PIK3CA predicted poor overall survival. The assay could be used to monitor emergence of resistance mutations such as in ESR1 that herald resistance to aromatase inhibitors to tailor adjuvant therapies. However, we suggest caution is needed when interpreting results from a single plasma sample as variants were also detected in a small proportion of HCs.
Issue Date: 24-Nov-2021
Date of Acceptance: 30-Jul-2021
URI: http://hdl.handle.net/10044/1/93071
DOI: 10.1200/PO.20.00522
ISSN: 2473-4284
Publisher: American Society of Clinical Oncology
Start Page: 1768
End Page: 1776
Journal / Book Title: JCO Precision Oncology
Volume: 5
Copyright Statement: © 2021 by American Society of Clinical Oncology. Licensed under the Creative Commons Attribution 4.0 License: https://creativecommons.org/licenses/by/4.0/
Sponsor/Funder: National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
Funder's Grant Number: NIHR-RP-011-053
RDB01 79560
Publication Status: Published
Conference Place: United States
Online Publication Date: 2021-11-24
Appears in Collections:Department of Immunology and Inflammation
Department of Surgery and Cancer



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