Researchers are exploring new methods to improve outcomes for patients with secondary breast cancer, a condition that is typically considered incurable and often fatal over time. A promising development in this field involves the use of liquid biopsies to detect cancer cell DNA circulating in the blood, a technique that could enable earlier intervention to prevent relapse.

Professor Nick Turner of the Royal Marsden Hospital is leading efforts to advance this technology, which identifies fragments of circulating tumour DNA (ctDNA) shed by residual cancer cells following initial treatment. This approach offers the potential to target these remaining cells before they multiply and form new tumours.

The use of liquid biopsies has several advantages over traditional diagnostic methods, such as needle biopsies guided by imaging, which are commonly required to sample secondary tumours located in internal organs like the liver, lungs, or bones. Such procedures can be uncomfortable and carry certain risks for patients. In contrast, ctDNA detection requires only a standard blood draw, making it easier to perform regularly and enabling continuous monitoring of treatment efficacy.

One of the major challenges in managing breast cancer is predicting which patients will experience relapse. To address this, Professor Turner is leading an ongoing multinational clinical study known as TRAK-ER. The trial, conducted across multiple hospitals in the United Kingdom and France, focuses on patients with estrogen receptor-positive (ER-positive) breast cancer, the subtype accounting for approximately 70 percent of breast cancer cases. While most individuals with this subtype achieve remission through surgery and hormone therapy, about 20 percent will experience a recurrence within 20 years.

The TRAK-ER trial seeks to use regular ctDNA blood tests to detect early signs of cancer recurrence before such changes become visible through conventional imaging techniques. By identifying patients at risk of relapse at an earlier stage, the study aims to inform timely treatment adjustments that may improve survival outcomes.

Thus far, the trial is progressing according to plan, and researchers hope that integrating liquid biopsy analyses into routine clinical practice could transform the management of secondary breast cancer. While curing the disease remains a significant challenge, the ability to monitor cancer progression more closely represents a notable advance in the ongoing effort to improve patient care and extend survival.