Use of ctDNA in Older Women with ER+ Breast Cancer to Facilitate Surgical De-escalation: A Prospective, Hybrid-Decentralized Trial with Correlative Studies - PubMed
3 hours ago
- #ctDNA
- #Surgical De-escalation
- #Breast Cancer
- Study explores ctDNA's role in older women with ER+ breast cancer to identify candidates for surgical de-escalation.
- Prospective, hybrid-decentralized trial (n=43) linked ctDNA levels with tumor progression in patients opting for primary endocrine therapy (pET) over surgery.
- Pretreatment ctDNA positivity significantly associated with tumor progression (HR, 30; 95% CI, 4.4-209; P=0.0011); no progression in ctDNA-negative cases.
- Correlative analyses revealed immunosuppressive macrophages in ctDNA-positive tumors progressing on pET, fostering cancer cell proliferation.
- Findings suggest ctDNA as a tool to safely guide long-term pET use in older patients, warranting randomized trials.