Intercepting late recurrence with ctDNA surveillance and oral SERDs
Half of hormone-positive recurrences happen after year five. Blood tests during long-term follow-up could find them early and an oral SERD might stop them.
Combine tumour-informed ctDNA surveillance in years 3-10 of adjuvant therapy with randomised intervention (add or switch to an oral SERD, or add a CDK4/6 inhibitor) at molecular relapse.
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