Integrating ctDNA Monitoring Into HR-Positive, HER2-Negative Advanced Breast Cancer Care

Dr. Jason Mouabbi and Dr. Seth Wander discuss the practical considerations surrounding the use of ctDNA monitoring in patients with HR-positive, HER2-negative advanced breast cancer. Dr. Mouabbi shares clinical perspectives on using ctDNA dynamics to better understand tumor behavior and identify emerging resistance mechanisms such as ESR1 mutations. Dr. Wander highlights the importance of patient-centered decision-making when considering biomarker-based monitoring strategies, emphasizing that approaches should account for individual patient preferences, clinical context, and evolving evidence. The experts discuss how minimally invasive molecular testing may provide additional insights beyond traditional imaging by helping identify changes in tumor biology over time. They also acknowledge the need to balance the potential benefits of proactive monitoring with considerations such as patient comfort and anxiety. The discussion reinforces the evolving role of personalized, biomarker-guided strategies in HR-positive, HER2-negative advanced breast cancer management.