How To Predict Whether Triple Negative Breast Cancer Will Recur / Come prevedere se il carcinoma mammario triplo negativo si ripresenterà
How To Predict Whether Triple Negative Breast Cancer Will Recur / Come prevedere se il carcinoma mammario triplo negativo si ripresenterà
Segnalato dal Dott. Giuseppe Cotellessa / Reported by Dr. Giuseppe Cotellessa
Indiana University School of Medicine researchers have discovered how to predict whether triple negative breast cancer will recur, and which women are likely to remain disease-free. They presented their findings at the San Antonio Breast Cancer Symposium, the most influential gathering of breast cancer researchers and physicians in the world.
Milan Radovich, Ph.D., and Bryan Schneider, M.D., discovered that women whose plasma contained genetic material from a tumor – referred to as circulating tumor DNA – had only a 56 percent chance of being cancer-free two years following chemotherapy and surgery. Patients who did not have circulating tumor DNA, or ctDNA, in their plasma had an 81 percent chance that the cancer would not return after the same amount of time.
Triple negative breast cancer is one of the most aggressive and deadliest types of breast cancer because it lacks common traits used to diagnose and treat most other breast cancers. Developing cures for the disease is a priority of the IU Precision Health Initiative Grand Challenge.
The study also examined the impact of circulating tumor cells, or CTCs, which are live tumor cells that are released from tumors somewhere in the body and float in the blood.
“What we found is that if patients were negative for both ctDNA and CTC, 90 percent of the women with triple negative breast cancer remained cancer-free after two years,” said Radovich, who is lead author of this study and associate professor of surgery and medical and molecular genetics at IU School of Medicine.
Radovich and Schneider are researchers in the Indiana University Melvin and Bren Simon Cancer Center and the Vera Bradley Foundation Center for Breast Cancer Research. They lead the Precision Health Initiative’s triple negative breast cancer team.
The researchers, along with colleagues from the Hoosier Cancer Research Network, analyzed plasma samples taken from the blood of 142 women with triple negative breast cancer who had undergone chemotherapy prior to surgery. Utilizing the FoundationOne Liquid Test, circulating tumor DNA was identified in 90 of the women; 52 were negative.
The women were participants in BRE12-158, a clinical study that tested genomically directed therapy versus treatment of the physician’s choice in patients with stage I, II or III triple negative breast cancer.
Detection of circulating tumor DNA was also associated with poor overall survival. Specifically, the study showed that patients with circulating tumor DNA were four times more likely to die from the disease when compared to those who tested negative for it.
The authors say the next step is a new clinical study expected to begin in early 2020, which utilizes this discovery to enroll patients who are at high risk for recurrence and evaluates new treatment options for them.
“Just telling a patient they are at high risk for reoccurrence isn’t overly helpful unless you can act on it,” said Schneider, who is senior author of this study and Vera Bradley Professor of Oncology at IU School of Medicine. “What’s more important is the ability to act on that in a way to improve outcomes.”
Milan Radovich, Ph.D., and Bryan Schneider, M.D., discovered that women whose plasma contained genetic material from a tumor – referred to as circulating tumor DNA – had only a 56 percent chance of being cancer-free two years following chemotherapy and surgery. Patients who did not have circulating tumor DNA, or ctDNA, in their plasma had an 81 percent chance that the cancer would not return after the same amount of time.
Triple negative breast cancer is one of the most aggressive and deadliest types of breast cancer because it lacks common traits used to diagnose and treat most other breast cancers. Developing cures for the disease is a priority of the IU Precision Health Initiative Grand Challenge.
The study also examined the impact of circulating tumor cells, or CTCs, which are live tumor cells that are released from tumors somewhere in the body and float in the blood.
“What we found is that if patients were negative for both ctDNA and CTC, 90 percent of the women with triple negative breast cancer remained cancer-free after two years,” said Radovich, who is lead author of this study and associate professor of surgery and medical and molecular genetics at IU School of Medicine.
Radovich and Schneider are researchers in the Indiana University Melvin and Bren Simon Cancer Center and the Vera Bradley Foundation Center for Breast Cancer Research. They lead the Precision Health Initiative’s triple negative breast cancer team.
The researchers, along with colleagues from the Hoosier Cancer Research Network, analyzed plasma samples taken from the blood of 142 women with triple negative breast cancer who had undergone chemotherapy prior to surgery. Utilizing the FoundationOne Liquid Test, circulating tumor DNA was identified in 90 of the women; 52 were negative.
The women were participants in BRE12-158, a clinical study that tested genomically directed therapy versus treatment of the physician’s choice in patients with stage I, II or III triple negative breast cancer.
Detection of circulating tumor DNA was also associated with poor overall survival. Specifically, the study showed that patients with circulating tumor DNA were four times more likely to die from the disease when compared to those who tested negative for it.
The authors say the next step is a new clinical study expected to begin in early 2020, which utilizes this discovery to enroll patients who are at high risk for recurrence and evaluates new treatment options for them.
“Just telling a patient they are at high risk for reoccurrence isn’t overly helpful unless you can act on it,” said Schneider, who is senior author of this study and Vera Bradley Professor of Oncology at IU School of Medicine. “What’s more important is the ability to act on that in a way to improve outcomes.”
ITALIANO
I ricercatori della Indiana University School of Medicine hanno scoperto come prevedere se il carcinoma mammario triplo negativo si ripresenterà e quali donne probabilmente rimarranno libere da malattia. Hanno presentato le loro scoperte al Simposio sul cancro al seno di San Antonio, il raduno più influente di ricercatori e medici del cancro al seno al mondo.
Milan Radovich, Ph.D. e Bryan Schneider, MD, hanno scoperto che le donne il cui plasma conteneva materiale genetico da un tumore - indicato come DNA tumorale circolante - avevano solo il 56% di probabilità di essere liberi dal cancro due anni dopo la chemioterapia e la chirurgia . I pazienti che non avevano DNA tumorale circolante o ctDNA nel loro plasma avevano una probabilità dell'81% che il cancro non sarebbe tornato dopo lo stesso lasso di tempo.
Il carcinoma mammario triplo negativo è uno dei tipi più aggressivi e mortali di carcinoma mammario in quanto privo di tratti comuni utilizzati per diagnosticare e trattare la maggior parte degli altri tumori al seno. Lo sviluppo di cure per la malattia è una priorità della IU Precision Health Initiative Grand Challenge.
Lo studio ha anche esaminato l'impatto delle cellule tumorali circolanti, o CTC, che sono cellule tumorali vive che vengono rilasciate da tumori da qualche parte nel corpo e galleggiano nel sangue.
"Quello che abbiamo scoperto è che se i pazienti erano negativi sia per ctDNA che per CTC, il 90% delle donne con carcinoma mammario triplo negativo rimaneva senza cancro dopo due anni", ha affermato Radovich, autore principale di questo studio e professore associato di chirurgia e genetica medica e molecolare presso la IU School of Medicine.
Radovich e Schneider sono ricercatori presso l'Università dell'Indiana Melvin e il Bren Simon Cancer Center e il Vera Bradley Foundation Center for Breast Cancer Research. Dirigono il team triplo negativo del carcinoma mammario della Precision Health Initiative.
I ricercatori, insieme ai colleghi della Hoosier Cancer Research Network, hanno analizzato campioni di plasma prelevati dal sangue di 142 donne con carcinoma mammario triplo negativo che erano stati sottoposti a chemioterapia prima dell'intervento chirurgico. Utilizzando il Test liquido FoundationOne, il DNA tumorale circolante è stato identificato in 90 donne; 52 erano negativi.
Le donne hanno partecipato a BRE12-158, uno studio clinico che ha testato la terapia genomicamente diretta rispetto al trattamento scelto dal medico in pazienti con carcinoma mammario triplo negativo di stadio I, II o III.
La rilevazione del DNA tumorale circolante era anche associata a una scarsa sopravvivenza globale. In particolare, lo studio ha mostrato che i pazienti con DNA tumorale circolante avevano una probabilità quattro volte maggiore di morire di malattia rispetto a quelli che ne erano risultati negativi.
Gli autori affermano che il prossimo passo è un nuovo studio clinico che dovrebbe iniziare all'inizio del 2020, che utilizza questa scoperta per arruolare pazienti ad alto rischio di recidiva e valuta nuove opzioni terapeutiche per loro.
"Il solo fatto di dire a un paziente che sono ad alto rischio di ricorrenza non è eccessivamente utile a meno che tu non possa agire su di esso", ha detto Schneider, autore senior di questo studio e Vera Bradley Professore di Oncologia presso la IU School of Medicine. "La cosa più importante è la capacità di agire su questo in modo da migliorare i risultati".
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