The research provides new insights into the prognostic value of ctDNA and its ability to guide personalized treatment strategies for triple-negative breast cancer (TNBC) patients
A cutting-edge study led by researchers at the Lady Davis Institute for Medical Research (LDI) with colleagues from Canada and published in Clinical Cancer Research, a journal of the American Association for Cancer Research, underscores the significant potential of a new blood test, liquid biopsy or circulating tumor DNA (ctDNA) for patients with an aggressive form of breast cancer, triple-negative breast cancer (TNBC). The research provides new insights into the prognostic value of ctDNA and its ability to guide personalized treatment strategies for these patients.
Indeed, TNBC patients usually receive chemotherapy prior to surgery in an effort to shrink the tumour. In most cases the tumour melts but in those that it does not, these patients with residual tumour at surgery have a poorer outcome, with a higher chance of the tumour coming back. For this reason, these patients receive extra chemotherapy after surgery. However, most of these patients still may not need this extra chemotherapy as the tumour will not return in the majority of cases, even in this poor prognosis group. Identifying those who would benefit or not from such additional therapy remains a critical need.
The study, conducted as part of the TRICIA trial, involved 92 TNBC patients who were evaluated for their response to neoadjuvant chemotherapy. Researchers found that the timely detection of ctDNA after chemotherapy and before surgery demonstrated exceptional sensitivity and specificity, and could predict with a 95% degree of accuracy whether the tumour would recur. This critical finding suggests that patients with a negative ctDNA test are less likely to benefit from additional chemotherapy, thus minimizing overtreatment and its associated toxicities.
“Identifying which patients can safely avoid unnecessary treatment is crucial for those diagnosed with triple-negative breast cancer, as they typically have poor outcomes,” said Dr. Mark Basik, surgical oncologist at the Segal Cancer Centre at the Jewish General Hospital (JGH) and senior investigator at the LDI. “Our results indicate that ctDNA detection can not only provide real-time insights into tumour dynamics but also assist in personalizing treatment plans, ultimately aiming to enhance patient outcomes.”
The study’s findings also indicate that ctDNA can be particularly effective in monitoring the efficacy of chemotherapy in real time. In patients who received the adjuvant chemotherapy capecitabine, ctDNA levels showed significant changes during treatment, correlating with patient outcomes. These findings suggest that ctDNA testing using our personalized assays in an academic hospital-based context can reliably identify a very low-risk group of non-pCR TNBC patients.
“This research highlights the promise of ctDNA as a reliable prognostic tool for triple-negative breast cancer patients,” Dr. Basik emphasized. “With further validation through prospective clinical trials, we can move towards a future where treatment decisions are guided by personalized biomarkers, improving survival rates and quality of life for our patients.”
Given the study’s promising results, researchers advocate for further clinical trials to establish ctDNA as a standard biomarker for prognosis, treatment monitoring, and decision-making in the management of TNBC.
The Basik laboratory is a member of the LUMIERE liquid biopsy group at the Lady Davis Institute for Medical Research/Jewish General Hospital, which brings together several groups working on liquid biopsies in different cancers.
Roseshter T, Klemantovich A, Lafleur J, Lan C, Cavallone L, Bozek K, Guay J, Elebute O, Jenna S, Ouellette R, McNamara S, Boileau JF, Pelmus M, Brackstone M, Pezo R, Ng T, Aguilar-Mahecha A, Basik M. Clinical Validation of Digital PCR-based ctDNA detection for risk stratification in residual triple negative breast cancer: TRICIA trial results. Clin Cancer Res. 2026. doi: 10.1158/1078-0432.CCR-25-2234.