Archives of Pathology & Laboratory Medicine,
Journal Year:
2018,
Volume and Issue:
142(10), P. 1242 - 1253
Published: March 5, 2018
Purpose.—
Clinical
use
of
analytical
tests
to
assess
genomic
variants
in
circulating
tumor
DNA
(ctDNA)
is
increasing.
This
joint
review
from
the
American
Society
Oncology
and
College
Pathologists
summarizes
current
information
about
clinical
ctDNA
assays
provides
a
framework
for
future
research.
Methods.—
An
Expert
Panel
conducted
literature
on
solid
tumors,
including
preanalytical
variables,
validity,
interpretation
reporting,
validity
utility.
Results.—
The
search
identified
1338
references.
Of
those,
390,
plus
31
references
supplied
by
Panel,
were
selected
full-text
review.
There
77
articles
inclusion.
Conclusions.—
evidence
indicates
that
testing
optimally
performed
plasma
collected
cell
stabilization
or
EDTA
tubes,
with
tubes
processed
within
6
hours
collection.
Some
have
demonstrated
utility
certain
types
advanced
cancer;
however,
there
insufficient
majority
cancer.
Evidence
shows
discordance
between
results
genotyping
specimens,
supports
tissue
confirm
undetected
tests.
no
little
early-stage
cancer,
treatment
monitoring,
residual
disease
detection.
suggest
are
useful
cancer
screening,
outside
trial.
Given
rapid
pace
research,
reevaluation
will
shortly
be
required,
along
development
tools
guidance
practice.
New England Journal of Medicine,
Journal Year:
2018,
Volume and Issue:
379(18), P. 1754 - 1765
Published: Oct. 31, 2018
Interview
with
Dr.
Ryan
Corcoran
on
the
potential
clinical
applications
of
cell-free
DNA
analysis
in
patients
cancer.
(10:36)Download
The
capacity
to
detect
new
cancers,
treatment-resistant
variants,
and
tumor
heterogeneity
by
noninvasive
technology
basis
blood
promises
revolutionize
cancer
detection,
prevention,
treatment.
Annals of Oncology,
Journal Year:
2018,
Volume and Issue:
29(7), P. 1541 - 1547
Published: April 25, 2018
BackgroundThe
phase
III
MONALEESA-2
study
demonstrated
significantly
prolonged
progression-free
survival
(PFS)
and
a
manageable
toxicity
profile
for
first-line
ribociclib
plus
letrozole
versus
placebo
in
patients
with
hormone
receptor-positive
(HR+),
human
epidermal
growth
factor
receptor
2-negative
(HER2–)
advanced
breast
cancer.
Here,
we
report
updated
efficacy
safety
data,
together
exploratory
biomarker
analyses,
from
the
study.Patients
methodsA
total
of
668
postmenopausal
women
HR+,
HER2–
recurrent/metastatic
cancer
were
randomized
(1
:
1;
stratified
by
presence/absence
liver
and/or
lung
metastases)
to
(600
mg/day;
3-weeks-on/1-week-off;
28-day
treatment
cycles)
(2.5
continuous)
or
letrozole.
The
primary
end
point
was
locally
assessed
PFS.
key
secondary
overall
(OS).
Other
points
included
response
rate
(ORR)
safety.
Biomarker
analysis
an
point.ResultsAt
time
second
interim
analysis,
median
duration
follow-up
26.4
months.
Median
PFS
25.3
months
[95%
confidence
interval
(CI)
23.0–30.3]
16.0
(95%
CI
13.4–18.2)
(hazard
ratio
0.568;
95%
0.457–0.704;
log-rank
P
=
9.63
×
10−8).
Ribociclib
benefit
maintained
irrespective
PIK3CA
TP53
mutation
status,
Rb,
Ki67,
p16
protein
expression,
CDKN2A,
CCND1,
ESR1
mRNA
levels.
more
pronounced
wild-type
altered
tyrosine
kinase
genes.
OS
data
remain
immature,
116
deaths
observed;
50
arm
66
0.746;
0.517–1.078).
ORR
42.5%
28.7%
all
treated
letrozole,
respectively,
54.5%
38.8%,
measurable
disease.
Safety
results,
after
further
11.1
follow-up,
comparable
those
reported
at
first
no
new
unexpected
toxicities
observed,
evidence
cumulative
toxicity.ConclusionsThe
improved
outcomes
tolerability
observed
are
longer
relative
monotherapy.Clinical
trials
numberNCT01958021
Journal of Clinical Oncology,
Journal Year:
2016,
Volume and Issue:
34(25), P. 2961 - 2968
Published: June 7, 2016
ESR1
mutations
are
selected
by
prior
aromatase
inhibitor
(AI)
therapy
in
advanced
breast
cancer.
We
assessed
the
impact
of
on
sensitivity
to
standard
therapies
two
phase
III
randomized
trials
that
represent
development
current
for
estrogen
receptor-positive
cancer.In
a
prospective-retrospective
analysis,
we
available
archived
baseline
plasma
from
SoFEA
(Study
Faslodex
Versus
Exemestane
With
or
Without
Arimidex)
trial,
which
compared
exemestane
with
fulvestrant-containing
regimens
patients
nonsteroidal
AI
and
PALOMA3
(Palbociclib
Combined
Fulvestrant
Hormone
Receptor-Positive
HER2-Negative
Metastatic
Breast
Cancer
After
Endocrine
Failure)
fulvestrant
plus
placebo
palbociclib
progression
after
receiving
endocrine
therapy.
were
analyzed
multiplex
digital
polymerase
chain
reaction.In
SoFEA,
found
39.1%
(63
161),
whom
49.1%
(27
55)
polyclonal,
rates
mutation
detection
unaffected
delays
processing
archival
plasma.
Patients
had
improved
progression-free
survival
(PFS)
taking
(n
=
45)
18;
hazard
ratio
[HR],
0.52;
95%
CI,
0.30
0.92;
P
.02),
whereas
wild-type
similar
PFS
either
treatment
(HR,
1.07;
0.68
1.67;
.77).
In
PALOMA3,
25.3%
(91
360),
28.6%
(26
91)
associated
acquired
resistance
AI.
both
mutant
0.43;
0.25
0.74;
.002)
0.49;
0.35
0.70;
<
.001).ESR1
analysis
may
help
direct
choice
further
endocrine-based
Additional
confirmatory
studies
required.
Biomolecular Detection and Quantification,
Journal Year:
2019,
Volume and Issue:
17, P. 100087 - 100087
Published: March 1, 2019
An
increasing
number
of
studies
demonstrate
the
potential
use
cell-free
DNA
(cfDNA)
as
a
surrogate
marker
for
multiple
indications
in
cancer,
including
diagnosis,
prognosis,
and
monitoring.
However,
harnessing
full
cfDNA
requires
(i)
optimization
standardization
preanalytical
steps,
(ii)
refinement
current
analysis
strategies,
and,
perhaps
most
importantly,
(iii)
significant
improvements
our
understanding
its
origin,
physical
properties,
dynamics
circulation.
The
latter
knowledge
is
crucial
interpreting
associations
between
changes
baseline
characteristics
clinical
manifestations
cancer.
In
this
review
we
explore
recent
advancements
highlight
gaps
concerning
each
point
contact
different
stages
cancer
management.