On June 9, 2025 Guardant Health, Inc. (Nasdaq: GH), a leading precision oncology company, reported results from the LIBERATE study published in ESMO (Free ESMO Whitepaper) Open (Press release, Guardant Health, JUN 9, 2025, View Source [SID1234653785]). The results in the peer-reviewed manuscript demonstrate the clinical validity and high performance of Guardant Reveal, the company’s minimal residual disease (MRD) blood test, in predicting recurrence in patients with early-stage breast cancer. Guardant Reveal uses epigenomic (methylation) analysis to detect circulating tumor DNA (ctDNA) in a patient’s blood without the need for a tissue sample.
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The LIBERATE study retrospectively analyzed 290 blood samples from 95 patients who were diagnosed with early-stage ER+/HER2- or triple negative breast cancer undergoing chemotherapy prior to surgery, half of whom had localized disease with no lymph node involvement. Nearly 40% had minimal or no residual tumor by pathologic assessment following neoadjuvant chemotherapy.
Key findings include:
High Sensitivity and Specificity: Guardant Reveal demonstrated 100% sensitivity for distant recurrence in patients with ER+/HER2- breast cancer (which represents about 70% of all breast cancers), and 71% overall, with 100% specificity and 100% positive predictive value for relapse.
Significant Prognostic Power: Detection of ctDNA post-operatively was significantly prognostic for event-free survival (EFS), with median lead time of 152 days (range: 15-748 days) ahead of clinical recurrence (P < 0.0001).
Nearly 100% of All Samples Evaluable: All patients with post-operative blood samples had MRD results available from Reveal, highlighting the power of a tissue-free MRD test among patients receiving neoadjuvant therapy, particularly the large percentage who have minimal to no tumor found at surgery.
"This study underscores the clinical validity, robust prognostic value and high specificity of Guardant Reveal in identifying breast cancer patients at elevated risk of recurrence without the need for a tissue sample," said Craig Eagle, M.D., Guardant Health chief medical officer. "These findings reinforce the critical role Reveal can achieve in clinical decision-making, potentially transforming neoadjuvant and post-treatment surveillance strategies and improving patient outcomes."
This publication adds to the growing body of evidence of Reveal’s strong performance in early-stage breast cancer. Earlier this year, a peer-reviewed publication in Clinical Cancer Research focused on stage II and III triple negative breast cancer demonstrated 83% sensitivity for metastatic recurrence and 99.5% sample-level specificity. Post-surgical ctDNA detection was prognostic for shorter recurrence-free interval (P < 0.0001). Additionally, ctDNA detection at the post-neoadjuvant, presurgical time point was associated with a shorter recurrence-free interval in patients with residual disease at surgery (P < 0.0001).