Acute circulating tumor DNA dynamics during and after systemic therapy initiation for advanced triple-negative breast cancer.

NPJ breast cancer
Authors
Abstract

Circulating tumor DNA (ctDNA) 'tumor fraction' (TF) may correlate with therapy response, but little is known regarding TF dynamics immediately after therapy initiation. Plasma samples from a single-arm clinical trial enrolling patients with triple-negative breast cancer were collected at a variety of time points following infusion of onalespib (day -7), paclitaxel (day 1), and onalespib + paclitaxel (day 8). 313 samples from 14 patients underwent shallow whole genome sequencing and TF determination. The primary objective was to evaluate TF change from pre-infusion to 6 h and 24 h post-infusion. There was significant TF decline from pre-infusion to 6 h for paclitaxel (p = 0.03) but no change for onalespib or onalespib+paclitaxel at 6hl. There was no ctDNA TF surge within minutes to 24 h of onalespib, paclitaxel, or combination, despite an overall decline in TF during the first therapy cycle. However, there was significant decline in TF from pre-infusion to D9 (16% to 6.5%, p = 0.004). These findings support further research on ctDNA dynamics immediately after therapy initiation.

Year of Publication
2026
Journal
NPJ breast cancer
Date Published
04/2026
ISSN
2374-4677
DOI
10.1038/s41523-026-00953-w
PubMed ID
41991549
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