Multiple time points for detecting circulating tumor DNA to monitor the response to neoadjuvant therapy in breast cancer: a meta-analysis
Abstract Background Not all breast cancer (BC) patients can benefit from neoadjuvant therapy (NAT). A poor response may result in patients missing the best opportunity for treatment, ultimately leading to a poor prognosis. Thus, to identify an effective predictor that can assess and predict patient...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12885-025-13526-0 |
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| author | Shuyi Niu Tie Sun Mozhi Wang Litong Yao Tianyi He Yusong Wang Hengjun Zhang Xiang Li Yingying Xu |
| author_facet | Shuyi Niu Tie Sun Mozhi Wang Litong Yao Tianyi He Yusong Wang Hengjun Zhang Xiang Li Yingying Xu |
| author_sort | Shuyi Niu |
| collection | DOAJ |
| description | Abstract Background Not all breast cancer (BC) patients can benefit from neoadjuvant therapy (NAT). A poor response may result in patients missing the best opportunity for treatment, ultimately leading to a poor prognosis. Thus, to identify an effective predictor that can assess and predict patient response at early time points, we focused on circulating tumor DNA (ctDNA), which is a vital noninvasive liquid biopsy biomarker. We performed a meta-analysis to explore the predictive value of response by monitoring ctDNA at four time points of NAT using pathologic complete response (pCR) and residual cancer burden (RCB). Methods By searching Embase, PubMed, the Cochrane Library, and the Web of Science until December 24, 2023, we selected studies concerning the relationship between ctDNA and response or prognosis. We analysed the results at the following various time points: baseline (T0), first cycle of NAT (T1), mid-treatment (MT), and end of NAT (EOT). pCR and RCB were used to evaluate the response as the primary endpoint. The secondary endpoint was to investigate the relationship between ctDNA and prognosis. Odds ratios (ORs) and hazard ratios (HRs) were used as effect indicators. Results Thirteen reports from twelve studies were eligible for inclusion in this meta-analysis. The results demonstrated that ctDNA negativity was associated with pCR at T1 (OR = 0.34; 95% CI: 0.21–0.57), MT (OR = 0.35; 95% CI: 0.20–0.60), and EOT (OR = 0.38; 95% CI: 0.22–0.66). When RCB was used to evaluate responses, ctDNA negativity was associated with RCB-0/I at the MT (OR = 0.34; 95% CI: 0.21–0.55) and EOT (OR = 0.26; 95% CI: 0.15–0.46). Furthermore, ctDNA positivity at T1 predicted a worse prognosis for patients (HR = 2.73; 95% CI: 1.29–5.75). We also performed a subgroup analysis to more accurately assess the predictive value of ctDNA for triple-negative breast cancer. Conclusions Our meta-analysis suggested that the ctDNA status at the early stage of NAT can predict patient response, which provides evidence for adjusting personalized treatment strategies and improving patient survival. Prospero registration number CRD42024496465. |
| format | Article |
| id | doaj-art-9a84f7f67f0a45e5905fe33ceb284862 |
| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Cancer |
| spelling | doaj-art-9a84f7f67f0a45e5905fe33ceb2848622025-01-26T12:37:47ZengBMCBMC Cancer1471-24072025-01-0125111310.1186/s12885-025-13526-0Multiple time points for detecting circulating tumor DNA to monitor the response to neoadjuvant therapy in breast cancer: a meta-analysisShuyi Niu0Tie Sun1Mozhi Wang2Litong Yao3Tianyi He4Yusong Wang5Hengjun Zhang6Xiang Li7Yingying Xu8Department of Breast Surgery, the First Hospital of China Medical UniversityThe Third Department of General Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital)Department of Breast Surgery, the First Hospital of China Medical UniversityDepartment of Breast Surgery, the First Hospital of China Medical UniversityDepartment of Breast Surgery, the First Hospital of China Medical UniversityDepartment of Breast Surgery, the First Hospital of China Medical UniversityDepartment of Breast Surgery, the First Hospital of China Medical UniversityDepartment of Breast Surgery, the First Hospital of China Medical UniversityDepartment of Breast Surgery, the First Hospital of China Medical UniversityAbstract Background Not all breast cancer (BC) patients can benefit from neoadjuvant therapy (NAT). A poor response may result in patients missing the best opportunity for treatment, ultimately leading to a poor prognosis. Thus, to identify an effective predictor that can assess and predict patient response at early time points, we focused on circulating tumor DNA (ctDNA), which is a vital noninvasive liquid biopsy biomarker. We performed a meta-analysis to explore the predictive value of response by monitoring ctDNA at four time points of NAT using pathologic complete response (pCR) and residual cancer burden (RCB). Methods By searching Embase, PubMed, the Cochrane Library, and the Web of Science until December 24, 2023, we selected studies concerning the relationship between ctDNA and response or prognosis. We analysed the results at the following various time points: baseline (T0), first cycle of NAT (T1), mid-treatment (MT), and end of NAT (EOT). pCR and RCB were used to evaluate the response as the primary endpoint. The secondary endpoint was to investigate the relationship between ctDNA and prognosis. Odds ratios (ORs) and hazard ratios (HRs) were used as effect indicators. Results Thirteen reports from twelve studies were eligible for inclusion in this meta-analysis. The results demonstrated that ctDNA negativity was associated with pCR at T1 (OR = 0.34; 95% CI: 0.21–0.57), MT (OR = 0.35; 95% CI: 0.20–0.60), and EOT (OR = 0.38; 95% CI: 0.22–0.66). When RCB was used to evaluate responses, ctDNA negativity was associated with RCB-0/I at the MT (OR = 0.34; 95% CI: 0.21–0.55) and EOT (OR = 0.26; 95% CI: 0.15–0.46). Furthermore, ctDNA positivity at T1 predicted a worse prognosis for patients (HR = 2.73; 95% CI: 1.29–5.75). We also performed a subgroup analysis to more accurately assess the predictive value of ctDNA for triple-negative breast cancer. Conclusions Our meta-analysis suggested that the ctDNA status at the early stage of NAT can predict patient response, which provides evidence for adjusting personalized treatment strategies and improving patient survival. Prospero registration number CRD42024496465.https://doi.org/10.1186/s12885-025-13526-0Circulating tumor DNABreast cancerNeoadjuvant therapyPrognosisResponseBiomarkers |
| spellingShingle | Shuyi Niu Tie Sun Mozhi Wang Litong Yao Tianyi He Yusong Wang Hengjun Zhang Xiang Li Yingying Xu Multiple time points for detecting circulating tumor DNA to monitor the response to neoadjuvant therapy in breast cancer: a meta-analysis BMC Cancer Circulating tumor DNA Breast cancer Neoadjuvant therapy Prognosis Response Biomarkers |
| title | Multiple time points for detecting circulating tumor DNA to monitor the response to neoadjuvant therapy in breast cancer: a meta-analysis |
| title_full | Multiple time points for detecting circulating tumor DNA to monitor the response to neoadjuvant therapy in breast cancer: a meta-analysis |
| title_fullStr | Multiple time points for detecting circulating tumor DNA to monitor the response to neoadjuvant therapy in breast cancer: a meta-analysis |
| title_full_unstemmed | Multiple time points for detecting circulating tumor DNA to monitor the response to neoadjuvant therapy in breast cancer: a meta-analysis |
| title_short | Multiple time points for detecting circulating tumor DNA to monitor the response to neoadjuvant therapy in breast cancer: a meta-analysis |
| title_sort | multiple time points for detecting circulating tumor dna to monitor the response to neoadjuvant therapy in breast cancer a meta analysis |
| topic | Circulating tumor DNA Breast cancer Neoadjuvant therapy Prognosis Response Biomarkers |
| url | https://doi.org/10.1186/s12885-025-13526-0 |
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