François Riva

[Guardant Health @GuardantHealth]

The largest MRD study to date in stage III #ColonCancer is now #Published in @JCO_ASCO. Results from the study show that ctDNA detection with the Guardant Reveal® blood test more precisely predicts recurrence and overall survival than standard staging, helping set a new standard for post-surgical risk assessment.

Thank you to principal investigator @FASinicropeMD, and our collaborators at @MayoClinic & @ALLIANCE_org for their partnership on this important work.

Details: https://t.co/zadb1zSO2y

[M.Provencio @MARIANOPROVENCI]

Minimal Residual Disease Enhances Prognostic Stratification Beyond Pathological Response in Resectable Non-Small Cell Lung Cancer https://t.co/neEjcE9iyM Working together as a team: 3 weeks 3 papers

[Armando Orlandi @ArmandOrlandi]

#7 ctDNA MRD: The Future is HERE

7️⃣ ctDNA MRD is THE prognostic marker! 🎯

GeparDouze in TNBC:
• MRD+ post-surgery: 78% recurred (7/9)
• MRD- post-surgery: 95% recurrence-free (131/138)
• HR for distant recurrence: 30.3 (p<1E-16) 🔥

PHERGain in HER2+:
• ctDNA+ at surgery → 0% pCR
• ctDNA- baseline → 100% 3y iDFS!

#ctDNA #MRD @OncoAlert

[MEDSIR @wearemedsir]

A significant day for #PHERGuide and our team at @SABCSSanAntonio 2025.

Proud to continue supporting research that informs clinical decisions and strengthens the future of precision oncology.

#SABCS2025 #BreastCancer #Oncology #CancerDeMama #ctDNA #HER2Positive

[Stephanie Graff, MD, FACP, FASCO @DrSGraff]

Using c-TRAK TN data, another compelling look at ctDNA dynamics and, critically, the role of tissue free ctDNA assays #SABCS25

[Armando Orlandi @ArmandOrlandi]

SERENA-6 Final PFS (RF7-03)

🧬 SERENA-6 Final Analysis: Switch early, win big!

Camizestrant + CDK4/6i at ESR1m emergence (BEFORE progression)

📊 315 patients | 18.7 months follow-up
Median PFS:
• CAMI + CDK4/6i: 16.6 months
• AI + CDK4/6i: 9.2 months
• HR 0.46 (p<0.00001) 🔥

ESR1m allele frequency at 8 weeks:
• CAMI arm: -100% (complete suppression!)
• AI arm: +66.7% (growing!)
PFS2: 25.7 vs 19.4 mo (HR 0.56)
Chemo/ADC-free survival: HR 0.69

💡 Liquid biopsy-guided early switch = extended 1L benefit
@OncoAlert @SABCSSanAntonio

[Armando Orlandi @ArmandOrlandi]

c-TRAK-TN Tissue-Free ctDNA (RF3-05)

🩸 No tumor tissue? No problem.
c-TRAK-TN: Tissue-free ctDNA (Guardant Reveal) vs ddPCR in early TNBC

Results are striking:
• 89.5% of relapses detected by prior ctDNA ✅
• HR 20.62 for relapse prediction (p<0.0001)
• 94.5% concordance with ddPCR

But tissue-free detected EARLIER:
• 44.8% detected first by tissue-free
• Only 6.9% detected first by ddPCR
• Median lead time: 7.9 vs 5.7 months

Simpler workflow. Earlier detection. Game changer? 🎯

[Susan G. Komen @SusanGKomen]

#SABCS25 update on PHERGain data in HER2+ early breast cancer: When tumor DNA in the blood cleared during HER2-targeted therapy, patients were more likely to have no invasive cancer at surgery and had better 3-year outcomes. A blood test that could help tailor treatment 🧬

[Stephanie Graff, MD, FACP, FASCO @DrSGraff]

ctDNA dynamics from pherGain summarized from @hthrparsons beautifully—
🚫Absence = excellent outcome
📉Clearance by cycle 3 associates with pCR
#SABCS25

[Armando Orlandi @ArmandOrlandi]

PHERGain ctDNA (GS1-06)

🧬 Can a blood test predict chemo-free success in HER2+ BC?

PHERGain says YES.
The smoking gun 🔫

NO patient with detectable ctDNA at surgery achieved pCR. Zero. Nada.

ctDNA clearance after just 2 cycles? → Strongly predicts pCR (p=0.003)
Baseline ctDNA+ → 3y iDFS 92.5%
Baseline ctDNA- → 3y iDFS 100%

Liquid biopsy meets de-escalation. Beautiful science. 🎯

@OncoAlert @SABCSSanAntonio

[Mridula George @MridulaGeorgeMD]

Role of ctDNA in TX based on results of PHERGAIN study. 37.9% omitted chemo
GuardantReveal assay was used
📌early ctDNA clearance was assoc with pCR
📌baseline ctDNA was assoc w worse 3y-IDFS
📌C3 and presurgery detect ctDNA had worse 3yIDFS
@OncoAlert #sabcs25

[Hope Rugo @hoperugo]

#SABC25 A Llombert phergain ctDNA dynamics HER2+ ESBC. 3/4 + at baseline. Poor clearance assoc with worse pCR and IDFS. This is an opportunity to individualize therapy based on a dynamic biomarker. @OncoAlert

[César A. Rodríguez 🩺 🐾 @1969carodriguez]

Great Presentation at #SABCS25 by Antonio Llombart
"Circulating tumor DNA (ctDNA) in human epidermal growth factor receptor 2-positive (HER2[+]) Early Breast Cancer (EBC): Translational analysis of PHERGain neoadjuvant tailored treatment study"
👏🏻
👇🏻

[Paolo Tarantino @PTarantinoMD]

Interesting sub-analysis from PherGAIN: early clearance of ctDNA at C3D1 predicted higher pCR and better outcomes for HER2+ eBC. Baseline ctDNA status also predictive of outcomes. Not ready for prime time, but extremely promising and warranting of further validation.

[Luca Arecco, MD @Lucarecco]

GS1-06 – #SABCS25
ctDNA predict pCR and outcomes in HER2+ eBC in PHERGain:
- ctDNA clearance after 2 cycles and pre-surgery strongly correlated w pCR
- Baseline ctDNA+ linked to worse 3y iDFS

➡️No patient with ctDNA+ before surgery achieved pCR !

@OncoAlert @SABCSSanAntonio

[Sergio Cifuentes @Onco_Cifu88]

🚨 SABCS25 Highlight | PHERGuide (PHERGain translational ctDNA analysis)
A major step forward in reshaping early HER2+ breast cancer management.

Key findings from this ctDNA-guided translational study:
🔬 Baseline insights:

• ctDNA detected in 71% of patients; associated with stage & nodal status.
• Baseline ctDNA did NOT predict pCR — reinforcing that tumor biology is dynamic, not static.
⚡ Early treatment dynamics:

• ctDNA clearance by C3D1 strongly correlated with pCR (p=0.003).
• Early molecular response outperformed baseline biomarkers.
🧬 Pre-surgery signal (most impactful):

• 83% achieved ctDNA clearance pre-surgery.
• 0% of patients with detectable ctDNA at surgery achieved pCR — a powerful negative predictive marker.
• Pre-surgery ctDNA positivity associated with worse 3-year iDFS.
📈 Survival:

• Both baseline ctDNA negativity and ctDNA clearance (early & late) predicted significantly better 3-year iDFS.
🌍 Why this matters now:

This study strengthens a growing paradigm:
ctDNA is emerging as an actionable tool to refine risk stratification, guide treatment escalation/de-escalation, and potentially reshape how we personalize therapy in early HER2+ disease—beyond imaging and pathology.
🔜 Clinical horizon:

• Identify high-risk patients who may benefit from novel escalation (e.g., T-DXd strategies).
• Support de-escalation trials for early molecular responders.
• Integrate methylation-based ctDNA assays into upcoming HER2+ adjuvant/neo-adjuvant designs.
An important translational contribution from PHERGain, pointing to the future of molecularly adaptive treatment in HER2+ eBC.

@OncoAlert @weoncologists @ReduzziCarol

[François Riva @OncoRiva]

@DFCI_BreastOnc @PietroDePlacido @drsarahsam @StefiMorganti @hthrparsons @DrDAbravanel @antgiorda @stolaney1 @nlinmd @RMJesel Wonderful work!!!

[François Riva @OncoRiva]

@bitcoin__cowboy @StephNoh @dan_olinger Yup! 💯.... And he's literally unguardable...Game 6 will be sick!

[François Riva @OncoRiva]

@Serna_Blasco @IASLC Congratulations! It was really good!

[François Riva @OncoRiva]

@ryenarussillo As a Bostonian living in Barcelona since '98, I just want to say that your analysis was really accurate! LMAO at various assessments.