Two trials aim to tackle relapse with liquid biopsies

FIGURING OUT HOW liquid biopsies could be used to predict cancer’s return is the focus of two new studies at The Royal Marsden.

The TRAK-ER trial aims to detect the signs of relapse earlier in oestrogen receptor-positive (ER+) breast cancer patients by looking for circulating tumour DNA (ctDNA) in the bloodstream.

Patients have a blood test every three months, for up to three years, and those identified as at risk of relapse will have their treatment altered to try to stop the disease coming back.

What is a liquid biopsy?

A liquid biopsy involves analysing blood samples to detect small fragments of genetic material that tumours release into the bloodstream, known as circulating tumour DNA. A sample can tell clinicians at an earlier stage if a patient is relapsing and can identify genetic mutations that could open up new options for targeted therapy.

Professor Nicholas Turner, Head of The Royal Marsden Cancer Charity-funded Ralph Lauren Centre for Breast Cancer Research and the Principal Investigator of the TRAK-ER trial, said: “The risk of relapse for ER+ breast cancer patients is spread out over many years after initial treatment. If the trial produces encouraging results, this could revolutionise how we treat these patients in the future.”

“Being part of something that may be able to give me forewarning of relapse is incredible. Anything that gives me a greater chance of being here for longer, and being well for longer, is amazing.”

Meanwhile, the TRACC part C study will look at whether liquid biopsies could help doctors decide whether to give chemotherapy to patients for stage 2 and 3 colorectal cancer. Testing for ctDNA following surgery can discover whether a patient still has minimal residual disease, and indicate whether or not they need further treatment.

Professor David Cunningham, Director of Clinical Research and the trial’s Chief Investigator, said: “Patients with high-risk colorectal cancer are often over-treated and can suffer long-term neurotoxicity from chemotherapy. This study will help us understand when we can avoid unnecessary chemotherapy for patients who have no disease detected following surgery.”

Want to know more?

To learn more about these trials and find out how to take part, please visit royalmarsden.nhs.uk/trak-er or royalmarsden.nhs.uk/tracc