Liquid Biopsy Can Guide Radiation Therapy in Early Stage Breast Cancer

Google+ Interview with:

Chelain Goodman, MD PhD PGY-3, Radiation Oncology Northwestern University Chicago, IL 60611

Dr. Goodman

Chelain Goodman, MD PhD
PGY-3, Radiation Oncology
Northwestern University
Chicago, IL 60611 What is the background for this study?

Response: Circulating tumor cells are cancer cells that are shed from the primary tumor into the peripheral blood stream and are hypothesized to be one of the first steps in the initiation of metastatic progression. Prospective studies have demonstrated that approximately 15-25% of patients with early-stage breast cancer can be found to have at least one circulating tumor cell in a small sample of their blood. Currently, all patients with early-stage invasive breast cancer who undergo breast conserving surgery receive adjuvant radiation therapy. In these analyses, we wanted to determine whether presence of circulating tumor cells may be predictive of benefit of radiation therapy following surgery. What are the main findings?

Response: We utilized the National Cancer Database as a discovery cohort and, as a validation cohort, performed a secondary analysis of the German Phase III SUCCESS Clinical Trial. In these analyses, we found that patients with early-stage breast cancer who were found to have at least one circulating tumor cell in their peripheral bloodstream demonstrated significantly longer survival and decreased risk of local recurrence if they received radiation therapy after breast conserving surgery. Interestingly, patients who did not have circulating tumor cells in their peripheral blood stream had excellent outcomes whether they received radiation therapy or not. What should clinicians and patients take away from your report?

Response: Circulating tumor cell status may be an important tool to help guide recommendations for radiation therapy following breast conserving surgery in patients with early-stage breast cancer. What recommendations do you have for future research as a result of this study?

Response: We are currently in the process of developing a prospective multicenter clinical trial to determine whether radiation therapy can be omitted following breast conserving surgery among women with early-stage low-risk breast cancer who do not have evidence of circulating tumor cells in their peripheral blood stream. Thank you for your contribution to the community.


Goodman CR, Seagle BL, Friedl TWP, et al. Association of Circulating Tumor Cell Status With Benefit of Radiotherapy and Survival in Early-Stage Breast Cancer. JAMA Oncol. Published online May 03, 2018. doi:10.1001/jamaoncol.2018.0163

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.








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