Personalized whole-genome-based ctDNA dynamics during neoadjuvant therapy across breast cancer subtypes…

ObservationalFuture oncology (London, England)· Jul 2026

Personalized whole-genome-based ctDNA dynamics during neoadjuvant therapy across breast cancer subtypes: results from MONITOR-Breast.

Julia Foldi, Gregory Hogan, Katherine Johansen Taber … Jeff Jasper

Molecular Genetic PathologyObservationalPrognosisQ1IF 2.6

Detectable ctDNA after neoadjuvant therapy strongly associated with residual breast cancer

Personalized whole-genome-based ctDNA dynamics during neoadjuvant therapy across breast cancer subtypes: results from MONITOR-Breast.

Julia Foldi … Jeff Jasper

Future oncology (London, England) · Jul 2026 · Q1 in General Medicine

Background

Circulating tumor DNA (ctDNA) shows promise as a therapy-response biomarker, but prior studies had limited sampling and assay sensitivity.

Purpose

Pathological complete response (pCR) after neoadjuvant therapy (neoadjuvant therapy) strongly associates with reduced breast cancer relapse risk.

Methods

In this prospective observational study, 154 enrolled patients with breast cancer (all subtypes, Stages I-III) were tested at baseline, throughout neoadjuvant therapy, and post-surgery using a whole genome sequencing-based molecular residual disease assay tracking up to 1,000 variants per patient.

n = 56 patients

OR>20

Results

OR>20

post-treatment ctDNA detection strongly predicts leftover tumor

n = 56 patients

More results

All 56 patients with CR and an evaluable sample had undetectable post-neoadjuvant therapy ctDNA.

More results

Frequent testing revealed distinct patterns: 78% achieved rapid and/or sustained ctDNA clearance, while 22% exhibited persistent or intermittent positivity, and had significantly higher residual disease (OR =52, p = 3 × 10 -9 ), and post-operative positivity (OR =25, p = 1 × 10 -5 ).

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Conclusion

Frequent, ultrasensitive ctDNA assessment provided comprehensive characterization of treatment response, revealing opportunities for de-escalation in early responders and escalation in those with persistent ctDNA.

Personalized whole-genome-based ctDNA dynamics during neoadjuvant therapy across breast cancer subtypes: results from MONITOR-Breast.

Personalized whole-genome-based ctDNA dynamics during neoadjuvant therapy across breast cancer subtypes: results from MONITOR-Breast.

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