Liquid biopsy-based clinical research in early breast cancer: The EORTC 90091-10093 Treat CTC trial.
There is increasing evidence that breast cancer evolves over time under the selection pressure of systemic treatment. Today, treatment decisions in early breast cancer are based on primary tumour characteristics without considering the disease evolution. Chemoresistant micrometastatic disease is poorly characterised and thus it is not used in current clinical practice as a tool to personalise treatment approaches. The detection of chemoresistant circulating tumour cells (CTCs) has been shown to be associated with worse prognosis in early breast cancer. The ongoing Treat CTC trial is the first international, liquid biopsy-based trial evaluating the concept of targeting chemoresistant minimal residual disease: detection of CTCs following adjuvant chemotherapy (adjuvant cohort) or neoadjuvant chemotherapy in patients who did not achieve pathological complete response (neoadjuvant cohort). This article presents the rational and design of this trial and the results of the pilot phase after 350 patients have been screened and provides insights that might provide information for future trials using the liquid biopsy approach as a tool towards precision medicine (NCT01548677).
Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. Electronic address: michail.ignatiadis@bordet.be.
Michail
M
Ignatiadis
Department of Gynecology and Obstetrics, Ludwig-Maximilians-Universität, Munich, Germany.
Brigitte
B
Rack
Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Francoise
F
Rothé
Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine, Hamburg, Germany.
Sabine
S
Riethdorf
Circulating Biomarker Lab, SIRIC, Institut Curie, Paris, France.
Charles
C
Decraene
Department of Medical Oncology, Institut Bergonié, Bordeaux, France.
Hervé
H
Bonnefoi
Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna) and ACR-ITR VIEnna, Kaiser Franz Josef-Spital, Kundratstrasse 3, 1100 Vienna, Austria.
Christian
C
Dittrich
Medical and Scientific Affairs, F. Hoffmann-La Roche AG, Diagnostics Division, Basel, Switzerland.
Carlo
C
Messina
European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.
Melanie
M
Beauvois
Department of Gynecology and Obstetrics, Ludwig-Maximilians-Universität, Munich, Germany.
Elisabeth
E
Trapp
Breast International Group Headquarters, Brussels, Belgium.
Theodora
T
Goulioti
European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.
Konstantinos
K
Tryfonidis
Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine, Hamburg, Germany.
Klaus
K
Pantel
Janssen Diagnostics LLC, NJ, USA.
Madeline
M
Repollet
Department of Gynecology and Obstetrics, Universitätsklinikum Ulm, Ulm, Germany.
Wolfgang
W
Janni
Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Martine
M
Piccart
Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Christos
C
Sotiriou
European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.
Saskia
S
Litiere
Circulating Biomarker Lab, SIRIC, Institut Curie, Paris, France; Medical Oncology Department, Institut Curie, Université Paris Descartes, France.
Jean-Yves
JY
Pierga
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy / Q000379:methods*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008875:Middle Aged; D018365:Neoplasm, Residual; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D000068878:Trastuzumab / Q000627:therapeutic use
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D000068878:Trastuzumab
Adjuvant treatment; Breast cancer; CTC