Everolimus in combination with endocrine treatment is a widely-used regimen in the management of ER+ metastatic breast cancer. Considering the toxicity and the costs of this treatment, identifying early on patients who will not derive any benefit is of upmost importance both medically and financially.
The phase II PEARL clinical trial (NCT 02028364) was developed for that purpose. It aimed to evaluate the clinical utility of an early F-FDG-PET/CT assessment (performed at day 14 after treatment initiation) as a biomarker to select ER+/HER2- MBC patients who will not derive benefit from this treatment combination.
In parallel, targeted gene sequencing was conducted on the sequential plasma samples collected during treatment in order to assess early circulating tumor DNA (ctDNA) dynamics and further characterize non-responders.
The PEARL study demonstrated that the absence of metabolic response and persistent ctDNA detection after only 14 days of EXE-EVE combination can select MBC patients with a low probability to derive long term treatment benefit.
OncoDNA is proud to have contributed to the study, along with the Institute Jules Bordet and other Belgian centers, by supporting the NGS analysis of the ctDNA extracted from the plasma samples.
Discover the scientific paper “FDG positron emission tomography imaging and ctDNA detection as an early dynamic biomarker of everolimus efficacy in advanced luminal breast cancer” published in Nature.