{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:16:44Z","timestamp":1788553004926,"version":"build-2803163510"},"reference-count":29,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Circulating tumor DNA (ctDNA) may serve as a biomarker to facilitate early identification of asymptomatic distant tumor spread in patients with breast cancer. The primary objective of this study was to assess clinical validity and prognostic value of post-treatment tissue-free ctDNA detection by evaluating its sensitivity for distant metastatic recurrence and its association with long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS AND METHODS<\/jats:title>\n                    <jats:p>\n                      Plasma samples were prospectively collected from patients with stage I-III early breast cancer who participated in the adjuvant SUCCESS-A phase III clinical trial (ClinicalTrials.gov identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT02181101\">NCT02181101<\/jats:ext-link>\n                      ). In this study, plasma samples collected approximately 2 years after completion of adjuvant chemotherapy from 313 SUCCESS A patients without evidence of prior disease recurrence were retrospectively analyzed using a tissue-free epigenomic ctDNA assay (Guardant Reveal). Survival analyses were performed using a landmark approach based on the time of sample collection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Overall, ctDNA was detected in 18 of 313 samples (5.8%). Of all ctDNA detected samples, 94% (17\/18) were from patients who subsequently developed a distant recurrence, with ctDNA detected at a median interval of 7.9 months before recurrence. ctDNA positivity was strongly associated with a significantly shorter distant recurrence-free interval (hazard ratio [HR], 33.3 [95% CI, 4.12 to 268];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001) and poorer overall survival (HR, 27.3 [95% CI, 1.15 to 647];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). The sensitivity for distant recurrence in patients who had a sample collected within 1 year before recurrence was 73% (11\/15). The specificity in nonrecurred patients was 99.6% (267\/268).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Tissue-free detection of ctDNA 2 years after adjuvant chemotherapy was highly prognostic in an early-stage breast cancer cohort, and can be used to stratify patients with early-stage breast cancer at high risk for recurrence during follow-up who may benefit from early interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/po-26-00095","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T19:59:13Z","timestamp":1788551953000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Relevance of Post-Treatment Circulating Tumor DNA Detection in Early Breast Cancer Using a Tissue-Free Epigenomic Assay: A 2-Year Landmark Analysis"],"prefix":"10.1200","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4773-8067","authenticated-orcid":true,"given":"Thomas W. P.","family":"Friedl","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4885-8471","authenticated-orcid":true,"given":"Peter A.","family":"Fasching","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1227-1118","authenticated-orcid":true,"given":"Andreas D.","family":"Hartkopf","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany"},{"name":"Department of Gynecology and Obstetrics, T\u00fcbingen University Hospital, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Tesch","sequence":"additional","affiliation":[{"name":"Department of Oncology, Onkologie Bethanien, Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Gynecologic Practice Dr Lorenz, N. Hecker, Dr Kreiss-Sender, Braunschweig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Heinrich","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Schwerpunktpraxis f\u00fcr Gyn\u00e4kologische Onkologie, F\u00fcrstenwalde, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7969-250X","authenticated-orcid":true,"given":"Jens-Uwe","family":"Blohmer","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Breast Center, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Fehm","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, D\u00fcsseldorf University Hospital, Heinrich-Heine University, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkmar","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Gynecology, University Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2429-4512","authenticated-orcid":true,"given":"Andreas","family":"Schneeweiss","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology and German Cancer Research Center, National Center for Tumor Diseases, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias W.","family":"Beckmann","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2408-1138","authenticated-orcid":true,"given":"Matthias","family":"Ruebner","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9744-7372","authenticated-orcid":true,"given":"Nadia","family":"Harbeck","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and CCC Munich, Breast Center, LMU University Hospital, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Pantel","sequence":"additional","affiliation":[{"name":"Institute of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"},{"name":"European Liquid Biopsy Society (ELBS), Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Dustin","sequence":"additional","affiliation":[{"name":"Guardant Health, Palo Alto, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8063-1002","authenticated-orcid":true,"given":"Mingyang","family":"Cai","sequence":"additional","affiliation":[{"name":"Guardant Health, Palo Alto, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7539-4839","authenticated-orcid":true,"given":"Brigitte","family":"Rack","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5911-2400","authenticated-orcid":true,"given":"Wolfgang","family":"Janni","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-024-00653-3"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-19-3005"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.00908"},{"key":"e_1_3_8_5_2","article-title":"Serial postoperative circulating tumor DNA assessment has strong prognostic value during long-term follow-up in patients with breast cancer","author":"Shaw JA","unstructured":"Shaw JA, Page K, Wren E, et al: Serial postoperative circulating tumor DNA assessment has strong prognostic value during long-term follow-up in patients with breast cancer. 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