Imperial College London


Faculty of MedicineDepartment of Surgery & Cancer

Professor of Molecular Endocrine Oncology



+44 (0)20 7594 2811simak.ali




133ICTEM buildingHammersmith Campus






BibTex format

author = {Coombes, RC and Page, K and Salari, R and Hastings, RK and Armstrong, A and Ahmed, S and Ali, S and Cleator, S and Kenny, L and Stebbing, J and Rutherford, M and Sethi, H and Boydell, A and Swenerton, R and Fernandez-Garcia, D and Gleason, KLT and Goddard, K and Guttery, DS and Assaf, ZJ and Wu, H-T and Natarajan, P and Moore, DA and Primrose, L and Dashner, S and Tin, AS and Balcioglu, M and Srinivasan, R and Shchegrova, SV and Olson, A and Hafez, D and Billings, P and Aleshin, A and Rehman, F and Toghill, BJ and Hills, A and Louie, MC and Lin, C-HJ and Zimmermann, BG and Shaw, JA},
doi = {10.1158/1078-0432.CCR-18-3663},
journal = {Clinical Cancer Research},
pages = {4255--4263},
title = {Personalized detection of circulating tumor DNA antedates breast cancer metastatic recurrence},
url = {},
volume = {25},
year = {2019}

RIS format (EndNote, RefMan)

AB - Purpose: Up to 30% of patients with breast cancer relapse after primary treatment. There are no sensitive and reliable tests to monitor these patients and detect distant metastases before overt recurrence. Here, we demonstrate the use of personalized circulating tumor DNA (ctDNA) profiling for detection of recurrence in breast cancer.Experimental Design: Forty-nine primary patients with breast cancer were recruited following surgery and adjuvant therapy. Plasma samples (n = 208) were collected every 6 months for up to 4 years. Personalized assays targeting 16 variants selected from primary tumor whole-exome data were tested in serial plasma for the presence of ctDNA by ultradeep sequencing (average >100,000X).Results: Plasma ctDNA was detected ahead of clinical or radiologic relapse in 16 of the 18 relapsed patients (sensitivity of 89%); metastatic relapse was predicted with a lead time of up to 2 years (median, 8.9 months; range, 0.5–24.0 months). None of the 31 nonrelapsing patients were ctDNA-positive at any time point across 156 plasma samples (specificity of 100%). Of the two relapsed patients who were not detected in the study, the first had only a local recurrence, whereas the second patient had bone recurrence and had completed chemotherapy just 13 days prior to blood sampling.Conclusions: This study demonstrates that patient-specific ctDNA analysis can be a sensitive and specific approach for disease surveillance for patients with breast cancer. More importantly, earlier detection of up to 2 years provides a possible window for therapeutic intervention.
AU - Coombes,RC
AU - Page,K
AU - Salari,R
AU - Hastings,RK
AU - Armstrong,A
AU - Ahmed,S
AU - Ali,S
AU - Cleator,S
AU - Kenny,L
AU - Stebbing,J
AU - Rutherford,M
AU - Sethi,H
AU - Boydell,A
AU - Swenerton,R
AU - Fernandez-Garcia,D
AU - Gleason,KLT
AU - Goddard,K
AU - Guttery,DS
AU - Assaf,ZJ
AU - Wu,H-T
AU - Natarajan,P
AU - Moore,DA
AU - Primrose,L
AU - Dashner,S
AU - Tin,AS
AU - Balcioglu,M
AU - Srinivasan,R
AU - Shchegrova,SV
AU - Olson,A
AU - Hafez,D
AU - Billings,P
AU - Aleshin,A
AU - Rehman,F
AU - Toghill,BJ
AU - Hills,A
AU - Louie,MC
AU - Lin,C-HJ
AU - Zimmermann,BG
AU - Shaw,JA
DO - 10.1158/1078-0432.CCR-18-3663
EP - 4263
PY - 2019///
SN - 1078-0432
SP - 4255
TI - Personalized detection of circulating tumor DNA antedates breast cancer metastatic recurrence
T2 - Clinical Cancer Research
UR -
UR -
UR -
VL - 25
ER -