Disseminated tumour cells from the bone marrow of early breast cancer patients: Results from an international pooled analysis
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Disseminated tumour cells from the bone marrow of early breast cancer patients: Results from an international pooled analysis. / Hartkopf, Andreas D; Brucker, Sara Y; Taran, Florin-Andrei; Harbeck, Nadia; von Au, Alexandra; Naume, Bjørn; Pierga, Jean-Yves; Hoffmann, Oliver; Beckmann, Matthias W; Rydén, Lisa; Fehm, Tanja; Aft, Rebecca; Solà, Montserrat; Walter, Vincent; Rack, Brigitte; Schuetz, Florian; Borgen, Elin; Ta, Minh-Hanh; Bittner, Ann-Kathrin; Fasching, Peter A; Fernö, Mårten; Krawczyk, Natalia; Weilbaecher, Katherine; Margelí, Mireia; Hahn, Markus; Jueckstock, Julia; Domschke, Christoph; Bidard, Francois-Clement; Kasimir-Bauer, Sabine; Schoenfisch, Birgitt; Kurt, Ayse G; Wallwiener, Markus; Gebauer, Gerhard; Klein, Christoph A; Wallwiener, Diethelm; Janni, Wolfgang; Pantel, Klaus.
In: EUR J CANCER, Vol. 154, 09.2021, p. 128-137.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Disseminated tumour cells from the bone marrow of early breast cancer patients: Results from an international pooled analysis
AU - Hartkopf, Andreas D
AU - Brucker, Sara Y
AU - Taran, Florin-Andrei
AU - Harbeck, Nadia
AU - von Au, Alexandra
AU - Naume, Bjørn
AU - Pierga, Jean-Yves
AU - Hoffmann, Oliver
AU - Beckmann, Matthias W
AU - Rydén, Lisa
AU - Fehm, Tanja
AU - Aft, Rebecca
AU - Solà, Montserrat
AU - Walter, Vincent
AU - Rack, Brigitte
AU - Schuetz, Florian
AU - Borgen, Elin
AU - Ta, Minh-Hanh
AU - Bittner, Ann-Kathrin
AU - Fasching, Peter A
AU - Fernö, Mårten
AU - Krawczyk, Natalia
AU - Weilbaecher, Katherine
AU - Margelí, Mireia
AU - Hahn, Markus
AU - Jueckstock, Julia
AU - Domschke, Christoph
AU - Bidard, Francois-Clement
AU - Kasimir-Bauer, Sabine
AU - Schoenfisch, Birgitt
AU - Kurt, Ayse G
AU - Wallwiener, Markus
AU - Gebauer, Gerhard
AU - Klein, Christoph A
AU - Wallwiener, Diethelm
AU - Janni, Wolfgang
AU - Pantel, Klaus
N1 - Copyright © 2021 Elsevier Ltd. All rights reserved.
PY - 2021/9
Y1 - 2021/9
N2 - PURPOSE: Presence of disseminated tumour cells (DTCs) in the bone marrow (BM) has been described as a surrogate of residual disease in patients with early breast cancer (EBC). PADDY (Pooled Analysis of DTC Detection in Early Breast Cancer) is a large international analysis of pooled data that aimed to assess the prognostic impact of DTCs in patients with EBC.EXPERIMENTAL DESIGN: Individual patient data were collected from 11 centres. Patients with EBC and available follow-up data in whom BM sampling was performed at the time of primary diagnosis before receiving any anticancer treatment were eligible. DTCs were identified by antibody staining against epithelial cytokeratins. Multivariate Cox regression was used to compare the survival of DTC-positive versus DTC-negative patients.RESULTS: In total, 10,307 patients were included. Of these, 2814 (27.3%) were DTC-positive. DTC detection was associated with higher tumour grade, larger tumour size, nodal positivity, oestrogen receptor and progesterone receptor negativity, and HER2 positivity (all p < 0.001). Multivariate analyses showed that DTC detection was an independent prognostic marker for overall survival, disease-free survival and distant disease-free survival with hazard ratios (HR) and 95% confidence intervals (CI) of 1.23 (95% CI: 1.06-1.43, p = 0.006), 1.30 (95% CI: 1.12-1.52, p < 0.001) and 1.30 (95% CI: 1.08-1.56, p = 0.006), respectively. There was no association between locoregional relapse-free survival and DTC detection (HR 1.21; 95% CI 0.68-2.16; p = 0.512).CONCLUSIONS: DTCs in the BM represent an independent prognostic marker in patients with EBC. The heterogeneous metastasis-initiating potential of DTCs is consistent with the concept of cancer dormancy.
AB - PURPOSE: Presence of disseminated tumour cells (DTCs) in the bone marrow (BM) has been described as a surrogate of residual disease in patients with early breast cancer (EBC). PADDY (Pooled Analysis of DTC Detection in Early Breast Cancer) is a large international analysis of pooled data that aimed to assess the prognostic impact of DTCs in patients with EBC.EXPERIMENTAL DESIGN: Individual patient data were collected from 11 centres. Patients with EBC and available follow-up data in whom BM sampling was performed at the time of primary diagnosis before receiving any anticancer treatment were eligible. DTCs were identified by antibody staining against epithelial cytokeratins. Multivariate Cox regression was used to compare the survival of DTC-positive versus DTC-negative patients.RESULTS: In total, 10,307 patients were included. Of these, 2814 (27.3%) were DTC-positive. DTC detection was associated with higher tumour grade, larger tumour size, nodal positivity, oestrogen receptor and progesterone receptor negativity, and HER2 positivity (all p < 0.001). Multivariate analyses showed that DTC detection was an independent prognostic marker for overall survival, disease-free survival and distant disease-free survival with hazard ratios (HR) and 95% confidence intervals (CI) of 1.23 (95% CI: 1.06-1.43, p = 0.006), 1.30 (95% CI: 1.12-1.52, p < 0.001) and 1.30 (95% CI: 1.08-1.56, p = 0.006), respectively. There was no association between locoregional relapse-free survival and DTC detection (HR 1.21; 95% CI 0.68-2.16; p = 0.512).CONCLUSIONS: DTCs in the BM represent an independent prognostic marker in patients with EBC. The heterogeneous metastasis-initiating potential of DTCs is consistent with the concept of cancer dormancy.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Bone Marrow/pathology
KW - Breast Neoplasms/mortality
KW - Female
KW - Humans
KW - Middle Aged
KW - Proportional Hazards Models
KW - Receptor, ErbB-2/analysis
KW - Young Adult
U2 - 10.1016/j.ejca.2021.06.028
DO - 10.1016/j.ejca.2021.06.028
M3 - SCORING: Journal article
C2 - 34265505
VL - 154
SP - 128
EP - 137
JO - EUR J CANCER
JF - EUR J CANCER
SN - 0959-8049
ER -
