Metastatic Breast Cancer Clinical Trial
Official title:
Characterization and Comparison of Drugable Mutations in Primary Tumors, Metastatic Tissue, Circulating Tumor Cells and Cell-Free Circulating DNA in Metastatic Breast Cancer Patients
Characterization of the driver mutations in an individual metastatic breast cancer patient is
critical for many reasons. Effective targeted therapies require identifying genomic
alterations in the tumoral tissue. The scarce efficacy of many currently available targeted
drugs may be due to the outbreak of resistant clones with different genotype that already
present at the initiation of therapy. It is well known the intra-tumor heterogeneity with
genetic and non-genetic factors considered as the origin of the tumor cell-clon composition.
The acquisition of multiple mutations (driver and passenger), altogether with the stage of
differentiation, according to the cancer stem cell hypothesis, confers to the tumor cells
clinically important properties, such as resistance to therapies and seeding abilities.
Moreover, there is a current challenge in establishing whether the metastatic cells arise
from the most aggressive and dominant clone in the primary tumor or the metastasic tissue
diverges with substantial genetic changes very early in the evolution of the disease. Primary
and metastatic tumor may have a close clonal relationship or evolve in parallel and acquire
different genomic alterations. In the real life, it is plausible that both models coexist
with different predominance according to the tumoral tissue and etiology.
The study hypothesizes that breast cancer metastases and primary tumors could harbor
different genomic profiles related to genomic regions of interest in a clinically relevant
proportion of metastatic breast cancer patients.
Moreover, the genomic aberrations found in the metastatic breast cancer tissue could also be
detected in CTCs and circulating free DNA.
If true, CTCs and circulating free DNA would be convenient, non-invasive, easily accessible
sources of genomic material for the analysis of mutations and other genomic aberrations.
n/a
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