Serial enumeration of circulating tumor cells predicts treatment response andprognosis in metastatic breast cancer: a prospective study in 393 patients
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Serial enumeration of circulating tumor cells predicts treatment response andprognosis in metastatic breast cancer: a prospective study in 393 patients. / Wallwiener, Markus; Riethdorf, Sabine; Hartkopf, Andreas Daniel; Modugno, Caroline; Nees, Juliane; Madhavan, Dharanija; Sprick, Martin Ronald; Schott, Sarah; Domschke, Christoph; Baccelli, Irène; Schönfisch, Birgitt; Burwinkel, Barbara; Marmé, Frederik; Heil, Jörg; Sohn, Christof; Pantel, Klaus; Trumpp, Andreas; Schneeweiss, Andreas.
in: BMC CANCER, Jahrgang 14, 11.07.2014, S. 512.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Serial enumeration of circulating tumor cells predicts treatment response andprognosis in metastatic breast cancer: a prospective study in 393 patients
AU - Wallwiener, Markus
AU - Riethdorf, Sabine
AU - Hartkopf, Andreas Daniel
AU - Modugno, Caroline
AU - Nees, Juliane
AU - Madhavan, Dharanija
AU - Sprick, Martin Ronald
AU - Schott, Sarah
AU - Domschke, Christoph
AU - Baccelli, Irène
AU - Schönfisch, Birgitt
AU - Burwinkel, Barbara
AU - Marmé, Frederik
AU - Heil, Jörg
AU - Sohn, Christof
AU - Pantel, Klaus
AU - Trumpp, Andreas
AU - Schneeweiss, Andreas
PY - 2014/7/11
Y1 - 2014/7/11
N2 - BACKGROUND: To prospectively assess circulating tumor cell (CTC) status at baseline (CTCBL) and after one cycle of a new line of systemic therapy (CTC1C), and changes from CTCBL to CTC1C (CTC kinetics, CTCKIN) for their utility in predicting response, progression-free (PFS) and overall survival (OS) in metastatic breast cancer (MBC).METHODS: CTCBL and CTC1C status was determined as negative (-) or positive (+) for < 5 or ≥ 5 CTCs/7.5 ml blood using CellSearch™ (Veridex). CTCKIN was categorized as favorable (CTC1C-) or unfavorable (CTC1C+). Tumor response was to be assessed every 2-3 months using the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Statistical analysis focused on the relation between CTC status and CTCKIN, and response, PFS, and OS.RESULTS: 133/393 (34%) patients enrolled were CTCBL+. CTC1C status after one cycle and radiological tumor response were assessed after median (range) periods of 1.2 (0.5-3.2) and 2.9 (0.5-4.8) months, respectively. 57/201 (28%) were CTC1C+. Median [95% confidence interval] PFS and OS (months) were significantly reduced in CTCBL+ vs. CTCBL- patients (PFS 4.7 [3.7-6.1] vs. 7.8 [6.4-9.2]; OS 10.4 [7.9-15.0] vs. 27.2 [22.3-29.9]), and for CTC1C+ vs. CTC1C- patients (PFS 4.3 [3.6-6.0] vs. 8.5 [6.6-10.4]; OS 7.7 [6.4-13.9] vs. 30.6 [22.6-not available]). Unfavorable CTCKIN was significantly associated with progressive disease. Multivariate Cox regression analysis revealed prognostic factors for shorter PFS (CTCBL+, persistent CTCs after one cycle, ≥ 3rd-line therapy, and triple-negative receptor status) and shorter OS (CTCBL+, persistent CTCs after one cycle, bone-and-visceral/local metastases, ≥ 3rd-line therapy, and triple-negative receptor status).CONCLUSIONS: CTCBL, CTC1C, and CTCKIN are predictive of outcome in MBC. Serial CTC enumeration is useful in tailoring systemic treatment of MBC.TRIAL REGISTRATION: Not applicable.
AB - BACKGROUND: To prospectively assess circulating tumor cell (CTC) status at baseline (CTCBL) and after one cycle of a new line of systemic therapy (CTC1C), and changes from CTCBL to CTC1C (CTC kinetics, CTCKIN) for their utility in predicting response, progression-free (PFS) and overall survival (OS) in metastatic breast cancer (MBC).METHODS: CTCBL and CTC1C status was determined as negative (-) or positive (+) for < 5 or ≥ 5 CTCs/7.5 ml blood using CellSearch™ (Veridex). CTCKIN was categorized as favorable (CTC1C-) or unfavorable (CTC1C+). Tumor response was to be assessed every 2-3 months using the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Statistical analysis focused on the relation between CTC status and CTCKIN, and response, PFS, and OS.RESULTS: 133/393 (34%) patients enrolled were CTCBL+. CTC1C status after one cycle and radiological tumor response were assessed after median (range) periods of 1.2 (0.5-3.2) and 2.9 (0.5-4.8) months, respectively. 57/201 (28%) were CTC1C+. Median [95% confidence interval] PFS and OS (months) were significantly reduced in CTCBL+ vs. CTCBL- patients (PFS 4.7 [3.7-6.1] vs. 7.8 [6.4-9.2]; OS 10.4 [7.9-15.0] vs. 27.2 [22.3-29.9]), and for CTC1C+ vs. CTC1C- patients (PFS 4.3 [3.6-6.0] vs. 8.5 [6.6-10.4]; OS 7.7 [6.4-13.9] vs. 30.6 [22.6-not available]). Unfavorable CTCKIN was significantly associated with progressive disease. Multivariate Cox regression analysis revealed prognostic factors for shorter PFS (CTCBL+, persistent CTCs after one cycle, ≥ 3rd-line therapy, and triple-negative receptor status) and shorter OS (CTCBL+, persistent CTCs after one cycle, bone-and-visceral/local metastases, ≥ 3rd-line therapy, and triple-negative receptor status).CONCLUSIONS: CTCBL, CTC1C, and CTCKIN are predictive of outcome in MBC. Serial CTC enumeration is useful in tailoring systemic treatment of MBC.TRIAL REGISTRATION: Not applicable.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Breast Neoplasms
KW - Disease-Free Survival
KW - Female
KW - Humans
KW - Middle Aged
KW - Neoplasm Metastasis
KW - Neoplastic Cells, Circulating
KW - Prospective Studies
KW - Treatment Outcome
KW - Tumor Markers, Biological
KW - Young Adult
U2 - 10.1186/1471-2407-14-512
DO - 10.1186/1471-2407-14-512
M3 - SCORING: Journal article
C2 - 25015676
VL - 14
SP - 512
JO - BMC CANCER
JF - BMC CANCER
SN - 1471-2407
ER -
