Sustained prognostic impact of circulating tumor cell status and kinetics upon further progression of metastatic breast cancer
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Sustained prognostic impact of circulating tumor cell status and kinetics upon further progression of metastatic breast cancer. / Jauch, Sarah F; Riethdorf, Sabine; Sprick, Martin R; Schütz, Florian; Schönfisch, Birgitt; Brucker, Sara Y; Deutsch, Thomas M; Nees, Juliane; Saini, Massimo; Becker, Lisa M; Burwinkel, Barbara; Sinn, Peter; Marmé, Frederik; Pantel, Klaus; Jäger, Dirk; Sohn, Christof; Trumpp, Andreas; Wallwiener, Markus; Schneeweiss, Andreas.
In: BREAST CANCER RES TR, Vol. 173, No. 1, 01.2019, p. 155-165.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Sustained prognostic impact of circulating tumor cell status and kinetics upon further progression of metastatic breast cancer
AU - Jauch, Sarah F
AU - Riethdorf, Sabine
AU - Sprick, Martin R
AU - Schütz, Florian
AU - Schönfisch, Birgitt
AU - Brucker, Sara Y
AU - Deutsch, Thomas M
AU - Nees, Juliane
AU - Saini, Massimo
AU - Becker, Lisa M
AU - Burwinkel, Barbara
AU - Sinn, Peter
AU - Marmé, Frederik
AU - Pantel, Klaus
AU - Jäger, Dirk
AU - Sohn, Christof
AU - Trumpp, Andreas
AU - Wallwiener, Markus
AU - Schneeweiss, Andreas
PY - 2019/1
Y1 - 2019/1
N2 - PURPOSE: Serial 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).METHODS: Among 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 ([Formula: see text] to [Formula: see text] and vice versa) was considered as alternating KineticsBL-PD.RESULTS: Median 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 [Formula: see text] patients ([Formula: see text] vs [Formula: see text], 11.4 [9.7, not available (NA)] vs. 7.6 [4.4, 11.5] months; P = 0.044) and [Formula: see text] patients ([Formula: see text] vs. [Formula: see text], 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.CONCLUSIONS: CTC 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.
AB - PURPOSE: Serial 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).METHODS: Among 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 ([Formula: see text] to [Formula: see text] and vice versa) was considered as alternating KineticsBL-PD.RESULTS: Median 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 [Formula: see text] patients ([Formula: see text] vs [Formula: see text], 11.4 [9.7, not available (NA)] vs. 7.6 [4.4, 11.5] months; P = 0.044) and [Formula: see text] patients ([Formula: see text] vs. [Formula: see text], 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.CONCLUSIONS: CTC 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.
KW - Journal Article
U2 - 10.1007/s10549-018-4972-y
DO - 10.1007/s10549-018-4972-y
M3 - SCORING: Journal article
C2 - 30276763
VL - 173
SP - 155
EP - 165
JO - BREAST CANCER RES TR
JF - BREAST CANCER RES TR
SN - 0167-6806
IS - 1
ER -