Sustained prognostic impact of circulating tumor cell status and kinetics upon further progression of metastatic breast cancer
PurposeSerial longitudinal enumeration of circulating tumor cells (CTCs) has shown its prognostic value on progression-free survival and overall survival (OS) in patients with stage IV breast cancer. This study prospectively evaluated the role of CTCs as a prognostic marker during further progressio...
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| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2019
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| In: |
Breast cancer research and treatment
Year: 2018, Volume: 173, Issue: 1, Pages: 155-165 |
| ISSN: | 1573-7217 |
| DOI: | 10.1007/s10549-018-4972-y |
| Online Access: | Verlag, Volltext: https://doi.org/10.1007/s10549-018-4972-y
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| Author Notes: | Sarah F. Jauch, Sabine Riethdorf, Martin R. Sprick, Florian Schütz, Birgitt Schönfisch, Sara Y. Brucker, Thomas M. Deutsch, Juliane Nees, Massimo Saini, Lisa M. Becker, Barbara Burwinkel, Peter Sinn, Frederik Marmé, Klaus Pantel, Dirk Jäger, Christof Sohn, Andreas Trumpp, Markus Wallwiener, Andreas Schneeweiss |
| Summary: | PurposeSerial longitudinal enumeration of circulating tumor cells (CTCs) has shown its prognostic value on progression-free survival and overall survival (OS) in patients with stage IV breast cancer. This study prospectively evaluated the role of CTCs as a prognostic marker during further progression of metastatic breast cancer (MBC).MethodsAmong 476 MBC patients recruited between 2010 and 2015, the 103 patients with a known CTC status at baseline (CTCBL) and within 4 weeks of tumor progression (CTCPD) were included. Progressive disease (PD) was defined according to the Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1). Using the CellSearch method, < 5 and ≥ 5 CTCs per 7.5 ml blood were determined as negative and positive, respectively. A shift in CTC status from baseline to progression (CTCBL+CTCBL+{\text {CTC}_\text {BL}}^+ to CTCPD−CTCPD−{\text {CTC}_\text {PD}}^- and vice versa) was considered as alternating KineticsBL-PD.ResultsMedian follow-up was 29.9 [21.2, 40.0] months. CTCPD positivity (37%, n = 38) was associated with a significantly shorter OS than CTCPD negativity (8.0 [5.1, 10.9] vs 22.6 [15.3, 39.8] months; P < 0.001). Alternating KineticsBL-PD was observed in 24% of the patients. This significantly changed the OS prediction of CTCBL+CTCBL+{\text {CTC}_\text {BL}}^+ patients (CTCBL+CTCPD−CTCBL+CTCPD−{{\text {CTC}_\text {BL}}^+}{{\text {CTC}_\text {PD}}^-} vs CTCBL+CTCPD+CTCBL+CTCPD+{{\text {CTC}_\text {BL}}^+}{{\text {CTC}_\text {PD}}^+}, 11.4 [9.7, not available (NA)] vs. 7.6 [4.4, 11.5] months; P = 0.044) and CTCBL−CTCBL−{\text {CTC}_\text {BL}}^- patients (CTCBL−CTCPD+CTCBL−CTCPD+{{\text {CTC}_\text {BL}}^-}{{\text {CTC}_\text {PD}}^+} vs. CTCBL−CTCPD−CTCBL−CTCPD−{{\text {CTC}_\text {BL}}^-}{{\text {CTC}_\text {PD}}^-}, 8.4 [4.0, NA] vs. 22.6 [18.9, NA] months, respectively; P < 0.001).Prediction of survival was significantly improved (P = 0.002) by adding CTCPD status to clinicopathological characteristics and CTCBL status.ConclusionsCTC status upon further disease progression is a prognostic factor that could significantly improve well-established models. Thus, it represents a potential additional instrument supporting treatment decision. |
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| Item Description: | First online: 01 October 2018 Gesehen am 27.06.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1573-7217 |
| DOI: | 10.1007/s10549-018-4972-y |