UNASSIGNED: Due to the spatial and temporal genomic heterogeneity of @entity0 , genomic sequencing obtained from a single biopsy may not capture the complete genomic profile of @entity5 . Thus, we propose that cell-free DNA (cfDNA) in plasma may be an alternate source of genomic information to provide comprehensive data throughout a @entity1 's clinical course. We performed a retrospective chart review of 100 @entity1 with stage 4 or high-risk stage 3 @entity0 . The degree of agreement between genomic alterations found in @entity5 DNA (tDNA) and cfDNA was determined by Cohen's Kappa. Clinical disease progression was compared to mutant allele frequency using a two-sided Fisher's exact test. The presence of mutations and mutant allele frequency was correlated with progression-free survival (PFS) using a Cox proportional hazards model and a log-rank test. The most commonly found genomic alterations were mutations in @entity876 and @entity10160 , and amplification of @entity470 and @entity1722 . @entity10160 mutation and @entity1722 amplification demonstrated robust agreement between tDNA and cfDNA (Cohen's kappa  =  0.64 and 0.77, respectively). @entity876 mutation and @entity470 amplification demonstrated poor agreement between tDNA and cfDNA (Cohen's kappa  =  0.18 and 0.33, respectively). The directional changes of @entity876 and @entity10160 mutant allele frequency were closely associated with response to therapy (p  =  0.002). The presence of @entity876 mutation (p  =  0.0004) and @entity10160 mutant allele frequency [p  =  0.01, HR 1.074 (95  % CI 1.018-1.134)] was excellent predictors of PFS. Identification of selected cancer-specific genomic alterations from cfDNA may be a noninvasive way to monitor disease progression, predict PFS, and offer targeted therapy.

Cell-free DNA as a molecular tool for monitoring disease progression and response to therapy in XXXX @entity1 .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity470 :: ('1956', 'Gene') :: ['EGFR'] @entity876 :: ('7157', 'Gene') :: ['TP53'] @entity10160 :: ('5290', 'Gene') :: ['PIK3CA'] @entity1722 :: ('2064', 'Gene') :: ['ERBB2']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
