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Half of hormone-positive recurrences happen after year five. Blood tests during long-term follow-up could find them early and an oral SERD might stop them.
This speculative idea would run tumour-informed ctDNA surveillance, such as Signatera, in years 3 to 10 of adjuvant endocrine therapy for HR-positive breast cancer and randomise women with molecular relapse to an oral SERD such as camizestrant or giredestrant, with or without a CDK4/6 inhibitor. Many recurrences occur after year five, ctDNA anticipates clinical relapse by around a year in the c-TRAK TN and ZEST experience, and dormant micrometastases may still be endocrine-sensitive. The hypothesis is that treating molecular relapse this way delays or prevents clinical distant recurrence. The test would be a TREAT-ctDNA or ZEST-style trial, where feasibility of detection is the first hurdle; the idea addresses the dormancy and minimal residual disease bottleneck.
Shares Late recurrence, Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), MRD / molecular residual disease testing.
Shares Camizestrant, a next-generation oral SERD, versus fulvestrant in post-menopausal women with oestrogen receptor-positive, HER2-negative advanced breast cancer (SERENA-2): a multi-dose, open-label, randomised, phase 2 trial, Camizestrant, HR-positive / HER2-negative breast cancer.
Shares Late recurrence, Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), MRD / molecular residual disease testing.
Shares Late recurrence, Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), MRD / molecular residual disease testing.
Shares Late recurrence, Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), MRD / molecular residual disease testing.
Shares Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), MRD / molecular residual disease testing, HR-positive / HER2-negative breast cancer.
Shares Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD), MRD / molecular residual disease testing, HR-positive / HER2-negative breast cancer.
Shares Giredestrant, Camizestrant, HR-positive / HER2-negative breast cancer.