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Cristofanilli Explains Precision of Liquid Biopsies in Advanced Breast Cancer

Brandon Scalea
Published: Thursday, Feb 07, 2019

Massimo Cristofanilli, MD

Massimo Cristofanilli, MD

In the pivotal SOLAR-1 trial, a liquid biopsy-based analysis of patients with breast cancer who harbored PIK3CA mutations was predictive of improved progression-free survival (PFS) outcomes with alpelisib, said Massimo Cristofanilli, MD. Cell-free DNA (cfDNA) was a major indicator of response to the drug, as it better reflected molecular status of the disease at the time of progression.

, Cristofanilli discussed the clinical utility of liquid biopsies—specifically focusing on CTCs and cfDNA—and highlighted ongoing research in the space.

OncLive: What were the key takeaways from the study you presented at the 2018 ASCO Annual Meeting?

Cristofanilli: CTCs have been described as being associated with bad outcomes in patients with advanced breast cancer and other tumor types. For many years, this has been known. The clinical use has been very difficult because it has never been associated with any predictive information. We felt that because the prognostic value of CTCs in advanced breast cancer is [well] known, we wanted to have a definitive study confirming that CTCs are not only a bad outcome but [are indicative of] a different disease. We took data from large European cohorts—almost 2000 cases—plus approximately 500 cases taken from The University of Texas MD Anderson Cancer Center. We combined these data and asked the question, “Can we identify patients who have worse outcomes in the overall population and in the de novo established disease?” If that was the case, we do have different diseases, because that is the basis of staging.
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