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Watch an exclusive “Ask the Expert” webinar: “Advancing Breast Cancer Treatment From Trials to Clinical Practice.”
Featuring renowned breast oncologist Dr. Eleonora Teplinsky, Head, Breast and Gynecological Medical Oncology, Valley-Mount Sinai Comprehensive Cancer Care, this session delves into the critical role of clinical trials in transforming breast cancer care, with a special focus on metastatic breast cancer (mBC).
**a summary of the discussion is below**
In the field of breast cancer treatment, monitoring disease progression and recurrence remains crucial. Signatera, a liquid biopsy test that detects circulating tumor DNA (ctDNA), has shown promise for identifying cancer DNA in the bloodstream, potentially predicting recurrence and guiding treatment decisions. However, Signatera’s application and utility vary significantly between early-stage and metastatic breast cancer.
1. Current Use of Signatera in Early-Stage Breast Cancer
While there is growing excitement around using ctDNA tests like Signatera to detect recurrence risk early, it is not yet commonly used in early-stage breast cancer. The reason? Medical experts currently lack protocols to act upon a positive result. If ctDNA is detected in early-stage patients, it may indicate a future recurrence risk, but treatment options to intervene based on this knowledge remain limited. Ongoing research aims to address whether modifying treatment based on ctDNA presence can reduce recurrence rates, but until more data is available, routine use of Signatera in early-stage breast cancer is not widely recommended.
2. Signatera in Metastatic Breast Cancer: Monitoring Disease Progression
In metastatic breast cancer, the approach to using Signatera differs. For some patients who do not produce standard tumor markers (like CA 27-29 or CA 15-3), Signatera can serve as an alternative to monitor cancer activity. However, this usage is selective and not applied to all metastatic patients, as other tumor markers or imaging scans are still the standard approach. For patients living long-term with metastatic disease, regular imaging scans are crucial for disease monitoring, and Signatera does not yet replace these scans.
3. Challenges with Reducing Imaging Scans
For metastatic breast cancer patients looking to reduce scan frequency due to the burden and radiation exposure, Signatera has not yet emerged as a complete alternative. Imaging remains the most reliable way to monitor disease progression. While the hope is that liquid biopsy tests like Signatera might one day help lessen scan frequency, research is still ongoing to determine its viability as a substitute.
In conclusion, while Signatera represents an exciting development in breast cancer monitoring, its use in early-stage settings is limited due to the lack of actionable steps following a positive result. In metastatic breast cancer, Signatera offers a supplemental tool for patients lacking traditional markers but does not replace regular imaging. Continued advancements and research will clarify how and when Signatera can best support breast cancer care across stages.
