Ensaios de ADNc personalizados com informação tumoral detectam MRD antes de recurrer clínica/ radiográfica...
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| ID | BMA-CTDNA-MRD-POST-TREATMENT-BREAST |
|---|---|
| Tipo | Relevância terapêutica |
| Estado | reviewed 2026-05-18 | actionability review required |
| Doenças | DIS-BREAST |
| Fontes | SRC-CIVIC SRC-ESMO-BREAST-METASTATIC-2024 SRC-NCCN-BREAST-2025 |
Fatos de ação
| Biomarcador | BIO-CTDNA-MRD-POST-TREATMENT |
|---|---|
| Variante | ctDNA doença residual mínima — pós-neoadjuvante/seio pós-adjuvante |
| Doença | DIS-BREAST |
| Nível ESCAT | IIIA |
| Resumo das provas | 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. |
Notas
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.
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