Dr Sharifi on the Importance of ctDNA Testing in Breast Cancer

Marina Sharifi, MD, PhD, medical oncologist, assistant professor, Department of Medicine, Division of Hematology, Medical Oncology and Palliative Care, the University of Wisconsin School of Medicine and Public Health, discusses the benefit of utilizing personalized and targeted therapy approaches in the treatment of patients with breast cancer.

Although advancements have been made with precision medicine across the breast cancer treatment landscape, there are remaining questions with the use of circulating tumor DNA (ctDNA) testing, Sharifi begins. Therefore, the potential roles of personalized approaches and targeted therapies are critical in the treatment of these patients and are vital to explore further through clinical investigations, she emphasizes. Sharifi shares that at the University of Wisconsin School of Medicine and Public Health, oncologists are overseeing the phase 2 PERSERVE trial (NCT04849364), which is investigating ctDNA in patients with triple-negative breast cancer (TNBC).

In this multi-institution study, patients who have completed treatment for TNBC receive ctDNA monitoring, and if a patient’s ctDNA comes back positive, depending on the mutations that are detected, the patient may be allocated to a treatment that targets their specific mutations, Sharifi expands. For example, a patient with a DNA repair alteration will be allocated to a PARP inhibitor, and a patient with a mutation in the PI3K pathway will be treated with a targeted treatment, she explains. Through this study, investigators can monitor patients for early signs of recurrence and can treat them with targeted therapies based on their ctDNA, Sharifi notes.

The further development of ctDNA testing will continue to foster a more personalized treatment approach for patients and, in turn, increase the likelihood of curing patients, Sharifi continues. Moving forward, the more that predictive biomarkers are integrated as a standard approach in the treatment of breast cancer, the more likely that the most beneficial treatment will be used for each patient, Sharifi says. This practice limits patients’ exposure to adverse effects from treatments that will not be effective in their specific disease, she concludes.