Jason Mouabbi, MD, is an assistant professor in the Department of Breast Medical Oncology in the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center in Houston.
Panelists emphasize that as circulating tumor DNA (ctDNA) testing becomes more integrated into clinical practice, careful interpretation, tailored testing schedules, and ongoing provider education are key to its effective use in personalized breast cancer care.
Panelists discuss the real-world challenges of managing patients with positive circulating tumor DNA (ctDNA) but no radiographic evidence of disease, emphasizing treatment intensification, genomic profiling for resistance mutations, dynamic monitoring, and the integration of ctDNA with imaging and biopsy to guide personalized breast cancer care.
Panelists discuss ongoing studies exploring circulating tumor DNA (ctDNA) use in the adjuvant breast cancer setting to detect recurrence earlier and guide therapy, highlighting advances in assay sensitivity, the choice between tumor-informed and tumor-agnostic tests, and the challenge of turning ctDNA’s strong prognostic value into actionable, outcome-improving interventions.
Panelists discuss how circulating tumor DNA (ctDNA) serves as a highly predictive prognostic biomarker in breast cancer, guiding personalized treatment intensification and informing important patient decisions while enhancing risk stratification and motivating proactive care despite ongoing research into its impact on long-term outcomes.
Panelists discuss how circulating tumor DNA (ctDNA) is becoming a vital biomarker in breast cancer, with its dynamic changes guiding personalized treatment decisions, serving as a surrogate end point in trials, enabling earlier detection of progression, and offering a less-invasive monitoring tool that complements imaging—especially benefiting patients with hard-to-monitor disease or those who are frail.
A panelist discusses how clinicians should exhaust all endocrine therapies plus targeted therapies before moving to chemotherapy or antibody-drug conjugates, while noting that different oral SERDs have varying adverse effect profiles that patients should be counseled about.
A panelist discusses how the EMBER-3 study results cannot be directly compared to those from EMERALD because of different patient populations, with EMBER-3 having fewer heavily pretreated patients and different baseline characteristics.
Panelists discuss how emerging data from studies like E-BLIS and I-SPY 2 validate circulating tumor DNA (ctDNA) as a powerful prognostic tool in early breast cancer, showing it can detect recurrence months before imaging and potentially refine risk stratification beyond traditional markers, though its role in guiding treatment decisions remains under active investigation.
Panelists discuss how circulating tumor DNA (ctDNA) monitoring provides a valuable lead time for detecting recurrence in early-stage breast cancer—especially hormone receptor–positive cases—yet requires careful patient counseling and integration with traditional prognostic tools, as its use for guiding treatment decisions remains nuanced and dependent on evolving clinical evidence.
Jason A. Mouabbi, MD, discusses the importance of achieving consensus for integrating CompassHER2-pCR data into early-stage HER2+ breast cancer management.
A panelist discusses how combination studies like ELEVATE are exploring elacestrant with other targeted therapies, showing promising results with ribociclib and everolimus combinations that are well-tolerated and efficacious.
A panelist discusses how real-world studies of elacestrant showed even better outcomes than clinical trials, with progression-free survival approaching 9 months, demonstrating the drug’s effectiveness in broader patient populations.
Panelists discuss how circulating tumor DNA (ctDNA) testing for molecular residual disease (MRD) offers a sensitive tool for detecting early breast cancer recurrence before clinical symptoms appear while emphasizing the importance of shared decision-making, patient education, and clinical trial referral in the absence of standardized guidelines for managing ctDNA-positive results.
Panelists discuss how current breast cancer surveillance remains largely symptom-driven and reactive, often missing early metastatic recurrence, and how circulating tumor DNA (ctDNA) testing offers a promising shift toward proactive, personalized monitoring by enabling earlier detection of molecular residual disease (MRD) and guiding timely therapeutic interventions.
A panelist discusses how elacestrant should be used as soon as ESR1 mutations emerge, emphasizing that it works equally well in visceral and bone metastases and that ESR1 mutations must be targeted before other mutations due to their resistance-driving nature.
A panelist discusses how the landmark EMERALD study established elacestrant as an effective treatment for heavily pretreated patients with ESR1 mutations, showing 8 to 9 months median progression-free survival versus less than 2 months with standard care.
A panelist discusses how the SERENA-6 study presented at ASCO 2025 showed that switching therapy early based on molecular progression (ESR1 mutation emergence) before radiological progression improved outcomes, with a 60% reduction in risk.
A panelist discusses how testing for ESR1 mutations should be performed after every progression using liquid biopsies and how elacestrant is currently the only approved oral SERD that effectively targets these mutations.
Jason A. Mouabbi, MD, discusses how ESR1 mutations can cause patients with HR-positive, HER2-negative breast cancer to develop endocrine resistance.
Jason A. Mouabbi, MD, discusses challenges associated with diagnosing and managing invasive lobular carcinoma
Jason A. Mouabbi, MD, discusses clinical trials aimed at expanding the treatment paradigm for invasive lobular breast cancer.
Jason Abdou Mouabbi, MD, discusses considerations for the use of ribociclib vs abemaciclib in patients with HR-positive, HER2-negative breast cancer.
