MRD Testing Poised to Revolutionize Breast Cancer Treatment, But Clinical Trials Lag
Rapid advancements in minimal residual disease (MRD) testing are generating excitement within the breast cancer community, offering the potential for highly personalized treatment strategies. While current approaches rely on probabilistic risk assessments, MRD – particularly through circulating tumor DNA (ctDNA) analysis – promises to pinpoint individual patient risk of recurrence and response to therapy with unprecedented accuracy. However, experts caution that robust clinical trials are crucial before widespread implementation to ensure patient safety and demonstrable improvements in outcomes.
The field is witnessing a “very, very fast” pace of technological development, with each new MRD test significantly surpassing the sensitivity of its predecessors. This progress fuels hope for refining treatment timelines, potentially shortening neoadjuvant therapy and accelerating the move to surgery when clearance is achieved. Currently, clinicians often operate with estimates – such as, a 10% to 20% likelihood of recurrence – lacking the ability to define a specific patient’s risk. MRD testing aims to bridge this gap, offering utility across neoadjuvant, adjuvant, and even metastatic settings.
Despite the promise, a critical need exists to validate the clinical utility of MRD testing. Concerns center around the potential for unsafe de-escalation of treatment based on negative MRD results, or conversely, unnecessary escalation based on positive findings.”We need to design clinical trials to prove that this is safe and this leads to an improved outcome for patients with breast cancer,” a leading expert emphasized, “because otherwise, the risk is to…give treatments that, at the end of the day, don’t really improve outcomes.”
These trials will be essential to determine how MRD data can be reliably translated into actionable clinical decisions, ultimately maximizing benefit and minimizing harm for individuals battling breast cancer.
REFERENCE
- Morganti S. Is MRD poised to transform oncology? Powerful tool has unanswered questions. Oncology News Central. Published November 21, 2024. Accessed November 17, 2025. https://tinyurl.com/7wueaya5
