Personalized tumor-informed ctDNA assays detect MRD before clinical/ radiographic recurre...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`BMA-CTDNA-MRD-POST-TREATMENT-BREAST`
Type	Actionability
Status	reviewed 2026-05-18 \| actionability review required
Diseases	`DIS-BREAST`
Sources	`SRC-CIVIC` `SRC-ESMO-BREAST-METASTATIC-2024` `SRC-NCCN-BREAST-2025`

Actionability Facts

Biomarker	`BIO-CTDNA-MRD-POST-TREATMENT`
Variant	ctDNA minimal residual disease — post-neoadjuvant / post-adjuvant breast
Disease	`DIS-BREAST`
ESCAT tier	IIIA
Evidence summary	Personalized tumor-informed ctDNA assays detect MRD before clinical/ radiographic recurrence in early breast cancer (median lead time 8-18 months). Garcia-Murillas 2019 (TNBC + HR+), Magbanua 2021 (I-SPY2), cTRAK-TN (Turner 2023 — preinvasion intervention with pembrolizumab in TNBC MRD+ failed). c-TRAK-TN-2, ZEST (Bidard 2024 — niraparib in MRD+ HER2-neg) accruing. ESMO Breast Metastatic 2024 notes ctDNA-MRD as emerging risk-stratification, NOT a treatment-escalation trigger outside trials. ESCAT IIIA.

Notes

STUB pending two-Co-Lead signoff. cTRAK-TN demonstrated that early pembrolizumab in MRD-positive TNBC did NOT prevent recurrence — caution against assuming MRD-guided escalation improves OS in breast. Engine must not surface MRD-positive as a treatment-intensification trigger outside trial enrolment (CHARTER §8.3). No post-treatment breast Indication entity yet ingests ctDNA-MRD status (future IND-BREAST-POST-PRIMARY-CTDNA-MRD-MONITORING). Indications: [] intentional.

Used By

No reverse references found in the YAML corpus.