Table 2.
Clinical studies on post-(neo)adjuvant therapy decisions in the case of post-therapeutic ctDNA positivity in early breast cancer (EBC). Overview of liquid biopsy-based studies in EBC patients with evidence of molecular relapse (detected by ctDNA monitoring) during follow-up (FU). as well as clinical trials on therapy monitoring using ctDNA in metastatic breast cancer (MBC) patients. ER = estrogen receptor. * Active not recruiting. ** Recruitment terminated prematurely.
| Study Name | NCT-Number | Phase | Stage | Inclusion Criteria | Intervention | Country/ Region |
|---|---|---|---|---|---|---|
| A Prospective, Phase II Trial Using ctDNA to Initiate Post-operation Boost Therapy After Adjuvant Chemotherapy in TNBC (Artemis) | NCT04803539 | II/III | EBC | TNBC, Stadium II-III | Capecitabin + Camrelizumab + Apatinib | China |
| Atezolizumab + Sacituzumab Govitecan to Prevent Recurrence in TNBC (ASPRIA) | NCT04434040 | II | EBC | TNBC, non-PCR (in the breast or lymph nodes) + circulating tumor DNA in the blood | Atezolizumab + Sacitzumab Govitecan | United States |
| Kadcyla And Neratinib for Interception of HER2+ Breast Cancer With Molecular Residual Disease (KAN-HER2 MRD) | NCT05388149 | II | EBC | HER2-positive, non-PCR, MRD after 2–6 cycles of adjuvant T-DM1 | Neratinib (together with T-DM1) | Canada |
| Circulating Tumor DNA Enriched, Genomically Directed Post-neoadjuvant Trial for Patients With Residual Triple Negative Breast Cancer (PERSEVERE) * | NCT04849364 | II | EBC | TNBC, non-PCR | Depending on mutation + Capecitabin | United States |
| Tirzepatide in Patients With Obesity or Overweight Who Have High Risk Early Breast Cancer and Are ctDNA+ | NCT06517212 | II | EBC | ER+ > 10%, HER2-, node-positive, body mass index > 27 kg/m2, ctDNA-positive | Tirzepatide | United States |
| Efficacy and Safety Comparison of Niraparib to Placebo in Participants With Human Epidermal Growth Factor 2 Negative (HER2-) Breast Cancer Susceptibility Gene Mutation (BRCAmut) or Triple-Negative Breast Cancer (TNBC) With Molecular Disease (ZEST) * | NCT04915755 | III | EBC | TNBC with presence of ctDNA or tumor BRCA mutation | Niraparib | United States |
| A Trial Using ctDNA Blood Tests to Detect Cancer Cells After Standard Treatment to Trigger Additional Treatment in Early Stage Triple Negative Breast Cancer Patients (c-TRAK-TN) ** | NCT03145961 | II | EBC/FU | TNBC/moderate or high risk | Pembrolizumab, if ctDNA is detected within 12 months during FU | United Kingdom |
| DNA-Guided Second Line Adjuvant Therapy For High Residual Risk, Stage II-III, Hormone Receptor Positive, HER2 Negative Breast Cancer (DARE) | NCT04567420 | II | FU | ER+/HER- high risk | Fulvestrant + Palbociclib | United States |
| CDK 4/6 Inhibitor, Ribociclib, With Adjuvant Endocrine Therapy for ER-positive Breast Cancer (LEADER) | NCT03285412 | II | FU | ER+/HER2- high risk, detectable ctDNA | Endocrine Therapy + Ribociclib | United States |
| A Randomized Secondary Adjuvant Treatment Intervention Study Comparing Trastuzumab-Deruxtecan to SOC Therapy in EBC Patients with Molecular Relapse (SURVIVE HERoes) * |
NCT06643585 | III | FU | HER2 positive or HER2 low, positive ctDNA result obtained in the SURVIVE study | Trastuzumab Deruxtecan | Germany |
| A Trial of Early Detection of Molecular Relapse With Circulating Tumour DNA Tracking and Treatment With Palbociclib Plus Fulvestrant Versus Standard Endocrine Therapy in Patients With ER Positive HER2 Negative Breast Cancer (TRAK-ER) | NCT04985266 | II | FU | ER+/HER2- high risk, detectable ctDNA | Fulvestrant + Palbociclib | France |
| Elacestrant for Treating ER+/HER2- Breast Cancer Patients With ctDNA Relapse (TREAT ctDNA) (TREAT ctDNA) | NCT05512364 | III | FU | ER+/HER2- high risk, ctDNA positive | Elacestrant | Belgium |
| Levels of Circulating Tumor DNA as a Predictive Marker for Early Switch in Treatment for Patients With Metastatic (Stage IV) Breast Cancer | NCT05826964 | II | MBC | ER+, HER2- metastatic breast cancer | Aromatase inhibitor vs. + CDK 4/6 inhibitor versus Fulvestrant + CDK 4/6 inhibitor | United States |
| Fulvestrant, Ipatasertib and CDK4/6 Inhibition in Metastatic ER+/HER2- Breast Cancer Patients Without ctDNA Suppression | NCT04920708 | II | MBC | ER+, HER2- metastatic breast cancer | Palbociclib and Fulvestrant and Ipatasertib vs. Palbociclib + and Fulvestrant | United Kingdom |
| Effect of Capivasertib on ctDNA in ER Positive Breast Cancer | NCT06613516 | II | MBC | ER +/HER2- metastatic breast cancer | Cabivasertib | United Kingdom |
| Liquid vs. Tissue Biopsy Concordance in Samples of 1st Suspected BCa Recurrence/Metastasis and Evaluation of DefineMBC Comprehensive Cancer Profiling Liquid Biopsy LDT | NCT04962529 | Observational trial | MBC | Progressive metastatic breast cancer | Tissue biopsy vs. liquid biopsy | United States |
| Trastuzumab Deruxtecan (T-DXd): Tailoring Treatment and Companion Diagnostics (CDx) by Liquid Biopsy | NCT05919212 | Exploratory study | MBC | HER2+ metastatic breast cancer | Liquid biopsy of HER2 status | Italy |
| Fulvestrant and everolimus efficacy after CDK4/6 inhibitor: a prospective study with circulating tumor DNA analysis | NCT02866149 | Exploratory study | MBC | ER+/HER2- metastatic breast cancer, pre-treatment with CDK 4/6 inhibitor | Fulvestrant and Everolimus | France |