Abstract PD5-05: Impact of circulating tumor DNA (ctDNA) surveillance on quality of life (QoL) for patients with early-stage breast cancer (EBC): prospective I-SURV study

Abstract Background: Detection of adjuvant ctDNA in EBC is strongly associated with recurrence. Prior data (Lipsyc-Sharf et al, ASCO 2024, 2025) identified patterns of ctDNA testing for minimal residual disease (MRD) surveillance in the real-world setting. However, the impact of MRD testing on patient QoL is unknown. Here, we present initial results from I-SURV, a prospective survey study evaluating the effect of MRD monitoring using adjuvant ctDNA testing on QoL in EBC patients. Methods: EBC Patients undergoing adjuvant ctDNA testing in a single academic institution provided informed consent prior to enrollment in this IRB-approved study. All tests were ordered as part of clinical care based on patient/oncologist shared decision-making. Participants completed electronic surveys to assess 1) validated measures of anxiety/depression (HADS), fear of recurrence (FCR-4), and QoL (FACT-Bv4) and 2) their opinion on ctDNA utility. Patients undergoing their first ctDNA test at time of enrollment (cohort 1) were asked to complete paired surveys before and after receiving test results. Patients that received ctDNA testing results before enrollment (cohort 2) completed only post-result surveys. Survey scores were summarized. Results: Between March-June 2025, 71 patients were enrolled. 58/71 (81.7%) patients completed at least 1 survey and comprised the analytic cohort (43 in cohort 1; 15 in cohort 2) (see Table 1 for median baseline survey scores). Overall, 30/58 (51.7%) patients had stage II-III EBC, 47/58 (81.0%) had grade 2-3 EBC, and 30/58 (51.7%) patients received prior chemotherapy. 13/43 (30.2%) of patients in cohort 1 completed paired surveys; the median time between surveys was 42 days (range 29-79). 12/13 (92.3%) patients with paired surveys tested ctDNA-. In these 12 patients, there was improvement in scores evaluating anxiety via HADS (median -1 -4 to -0.5), depression via HADS (median -0.5 -1 to +2), fear of recurrence via FCR-4 (median -2 -4.3 to -0.8) and QoL via FACT-B (median +4 0 to +12). For the 1 patient tested ctDNA+, fear of recurrence via FCR-4 worsened (increased from low to high-fear category) as did QoL (FACT-B score decreased by 25 points). Among patients in cohort 2, all had prior ctDNA- result. Altogether, 54/58 (93.1%) participants valued the information provided by ctDNA testing and 52/58 (89.7%) wished to continue ctDNA surveillance. Updated data will be presented at the conference if selected. Conclusion: We studied the impact of adjuvant ctDNA testing on QoL in the real-world setting in EBC. Preliminary results suggest that most patients in this study value ctDNA surveillance and would like to continue. Patients who received a ctDNA- result had reduced anxiety and fear of recurrence. These data will guide the design of multicenter studies powered to investigate the impact of ctDNA surveillance on QoL among EBC patients. Citation Format: C. Cheng, S. Sanchez Seyeddi, E. Brierley-Green, D. Vaghashia, M. Berkowitz, R. Callahan, B. DiCarlo, A. Master, J. Penn, M. S. Sedrak, A. Medford, C. Gianni, B. Pastò, C. Reduzzi, S. Tapiavala, E. Podany, A. A. Davis, M. Cristofanilli, A. Bardia, M. Lipsyc-Sharf. Impact of circulating tumor DNA (ctDNA) surveillance on quality of life (QoL) for patients with early-stage breast cancer (EBC): prospective I-SURV study abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PD5-05.