Review Article|Articles in Press

Circulating Tumor DNA as a Novel Biomarker Optimizing Treatment for Triple Negative Breast Cancer

Published:March 01, 2023DOI:


      • Circulating tumor DNA (ctDNA) has become a sensitive and specific biomarker to identify TNBC at early stage, monitoring of minimal residual disease, prognosis, and treatment response.
      • Standard treatment for patients with TNBC does not differ while the presence of ctDNA indicates high risk of recurrence. An adequate precision therapy has yet to be identified based on the status of ctDNA, for those with high risk of relapse (ie, ctDNA positivity), it may be benefit in treatment-escalation in the adjuvant therapy.
      • ctDNA has been used in management of precise therapy in on-going clinical trials.


      Triple-negative breast cancer is a sub-type of clinically and molecularly heterogeneous malignant disease with a worse prognosis and earlier recurrence than HER2-amplified or hormone-receptor positive breast cancer. Because of the lack of personalized therapy, genetic information is essential to early diagnosing, identifying the high risk of recurrence, guiding therapeutic management, and monitoring treatment efficiency. Circulating tumor DNA (ctDNA) is a novel noninvasive, timely, and tumor specified biomarker that reliably reflects the comprehensive tumor genetic profiles. Thus, it holds significant expectations in personalized therapy, including accurate diagnosis, treatment monitoring, and early detection of recurrence of TNBC. In this review, we summarize the results from recent and ongoing ctDNA-based biomarker-driven clinical trials, with respect to ctDNA analysis' predictive role, in adjuvant, neo-adjuvant, and metastatic settings. Collectively, we anticipate that ctDNA will ultimately be integrated into the management of TNBC to foster precise treatment.


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