Circulating tumor cells as prognostic and predictive markers in metastatic breast cancer patients receiving first-line systemic treatment
Introduction Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the prognostic impact of CTCs according to different first-line systemic treatments, and explored their potential predictive value in MBC patients. M...
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| Published in | Breast cancer research : BCR Vol. 13; no. 3; p. R67 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
BioMed Central
15.06.2011
BioMed Central Ltd |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1465-542X 1465-5411 1465-542X |
| DOI | 10.1186/bcr2907 |
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| Abstract | Introduction
Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the prognostic impact of CTCs according to different first-line systemic treatments, and explored their potential predictive value in MBC patients.
Methods
We retrospectively evaluated 235 newly diagnosed MBC patients, treated at the University of Texas MD Anderson Cancer Center. All patients had a baseline CTC assessment performed with CellSearch
®
. Progression-free survival and overall survival were compared with the log-rank test between groups, according to CTC count (< 5 vs. ≥ 5) and type of systemic therapy. We further explored the predictive value of baseline CTCs in patients receiving different treatments.
Results
At a median follow-up of 18 months, the CTC count was confirmed to be a robust prognostic marker in the overall population (median progression-free survival 12.0 and 7.0 months for patients with CTC < 5 and ≥ 5, respectively;
P
< 0.001). Conversely, in patients with human epidermal growth factor receptor-2-overexpressed/amplified tumors receiving trastuzumab or lapatinib, the baseline CTC count was not prognostic (median progression-free survival 14.5 months for patients with CTC < 5 and 16.1 months for those with CTC ≥ 5;
P
= 0.947). Furthermore, in patients with human epidermal growth factor receptor-2 normal tumors, a baseline CTC count ≥ 5 identified subjects who derived benefit from more aggressive treatments, including combination chemotherapy and chemotherapy plus bevacizumab.
Conclusions
This analysis suggests that the prognostic information provided by CTC count may be useful in patient stratifications and therapeutic selection, particularly in the group with positive CTCs, in which various therapeutic choices may procure differential palliative benefit. |
|---|---|
| AbstractList | Introduction
Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the prognostic impact of CTCs according to different first-line systemic treatments, and explored their potential predictive value in MBC patients.
Methods
We retrospectively evaluated 235 newly diagnosed MBC patients, treated at the University of Texas MD Anderson Cancer Center. All patients had a baseline CTC assessment performed with CellSearch
®
. Progression-free survival and overall survival were compared with the log-rank test between groups, according to CTC count (< 5 vs. ≥ 5) and type of systemic therapy. We further explored the predictive value of baseline CTCs in patients receiving different treatments.
Results
At a median follow-up of 18 months, the CTC count was confirmed to be a robust prognostic marker in the overall population (median progression-free survival 12.0 and 7.0 months for patients with CTC < 5 and ≥ 5, respectively;
P
< 0.001). Conversely, in patients with human epidermal growth factor receptor-2-overexpressed/amplified tumors receiving trastuzumab or lapatinib, the baseline CTC count was not prognostic (median progression-free survival 14.5 months for patients with CTC < 5 and 16.1 months for those with CTC ≥ 5;
P
= 0.947). Furthermore, in patients with human epidermal growth factor receptor-2 normal tumors, a baseline CTC count ≥ 5 identified subjects who derived benefit from more aggressive treatments, including combination chemotherapy and chemotherapy plus bevacizumab.
Conclusions
This analysis suggests that the prognostic information provided by CTC count may be useful in patient stratifications and therapeutic selection, particularly in the group with positive CTCs, in which various therapeutic choices may procure differential palliative benefit. Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the prognostic impact of CTCs according to different first-line systemic treatments, and explored their potential predictive value in MBC patients.INTRODUCTIONCirculating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the prognostic impact of CTCs according to different first-line systemic treatments, and explored their potential predictive value in MBC patients.We retrospectively evaluated 235 newly diagnosed MBC patients, treated at the University of Texas MD Anderson Cancer Center. All patients had a baseline CTC assessment performed with CellSearch(®). Progression-free survival and overall survival were compared with the log-rank test between groups, according to CTC count (< 5 vs. ≥ 5) and type of systemic therapy. We further explored the predictive value of baseline CTCs in patients receiving different treatments.METHODSWe retrospectively evaluated 235 newly diagnosed MBC patients, treated at the University of Texas MD Anderson Cancer Center. All patients had a baseline CTC assessment performed with CellSearch(®). Progression-free survival and overall survival were compared with the log-rank test between groups, according to CTC count (< 5 vs. ≥ 5) and type of systemic therapy. We further explored the predictive value of baseline CTCs in patients receiving different treatments.At a median follow-up of 18 months, the CTC count was confirmed to be a robust prognostic marker in the overall population (median progression-free survival 12.0 and 7.0 months for patients with CTC < 5 and ≥ 5, respectively; P < 0.001). Conversely, in patients with human epidermal growth factor receptor-2-overexpressed/amplified tumors receiving trastuzumab or lapatinib, the baseline CTC count was not prognostic (median progression-free survival 14.5 months for patients with CTC < 5 and 16.1 months for those with CTC ≥ 5; P = 0.947). Furthermore, in patients with human epidermal growth factor receptor-2 normal tumors, a baseline CTC count ≥ 5 identified subjects who derived benefit from more aggressive treatments, including combination chemotherapy and chemotherapy plus bevacizumab.RESULTSAt a median follow-up of 18 months, the CTC count was confirmed to be a robust prognostic marker in the overall population (median progression-free survival 12.0 and 7.0 months for patients with CTC < 5 and ≥ 5, respectively; P < 0.001). Conversely, in patients with human epidermal growth factor receptor-2-overexpressed/amplified tumors receiving trastuzumab or lapatinib, the baseline CTC count was not prognostic (median progression-free survival 14.5 months for patients with CTC < 5 and 16.1 months for those with CTC ≥ 5; P = 0.947). Furthermore, in patients with human epidermal growth factor receptor-2 normal tumors, a baseline CTC count ≥ 5 identified subjects who derived benefit from more aggressive treatments, including combination chemotherapy and chemotherapy plus bevacizumab.This analysis suggests that the prognostic information provided by CTC count may be useful in patient stratifications and therapeutic selection, particularly in the group with positive CTCs, in which various therapeutic choices may procure differential palliative benefit.CONCLUSIONSThis analysis suggests that the prognostic information provided by CTC count may be useful in patient stratifications and therapeutic selection, particularly in the group with positive CTCs, in which various therapeutic choices may procure differential palliative benefit. Introduction Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the prognostic impact of CTCs according to different first-line systemic treatments, and explored their potential predictive value in MBC patients. Methods We retrospectively evaluated 235 newly diagnosed MBC patients, treated at the University of Texas MD Anderson Cancer Center. All patients had a baseline CTC assessment performed with CellSearch.sup.[R].sup.. Progression-free survival and overall survival were compared with the log-rank test between groups, according to CTC count ([less than] 5 vs. [greater than or equal to] 5) and type of systemic therapy. We further explored the predictive value of baseline CTCs in patients receiving different treatments. Results At a median follow-up of 18 months, the CTC count was confirmed to be a robust prognostic marker in the overall population (median progression-free survival 12.0 and 7.0 months for patients with CTC [less than] 5 and [greater than or equal to] 5, respectively; P [less than] 0.001). Conversely, in patients with human epidermal growth factor receptor-2-overexpressed/amplified tumors receiving trastuzumab or lapatinib, the baseline CTC count was not prognostic (median progression-free survival 14.5 months for patients with CTC [less than] 5 and 16.1 months for those with CTC [greater than or equal to] 5; P = 0.947). Furthermore, in patients with human epidermal growth factor receptor-2 normal tumors, a baseline CTC count [greater than or equal to] 5 identified subjects who derived benefit from more aggressive treatments, including combination chemotherapy and chemotherapy plus bevacizumab. Conclusions This analysis suggests that the prognostic information provided by CTC count may be useful in patient stratifications and therapeutic selection, particularly in the group with positive CTCs, in which various therapeutic choices may procure differential palliative benefit. Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the prognostic impact of CTCs according to different first-line systemic treatments, and explored their potential predictive value in MBC patients. We retrospectively evaluated 235 newly diagnosed MBC patients, treated at the University of Texas MD Anderson Cancer Center. All patients had a baseline CTC assessment performed with CellSearch(®). Progression-free survival and overall survival were compared with the log-rank test between groups, according to CTC count (< 5 vs. ≥ 5) and type of systemic therapy. We further explored the predictive value of baseline CTCs in patients receiving different treatments. At a median follow-up of 18 months, the CTC count was confirmed to be a robust prognostic marker in the overall population (median progression-free survival 12.0 and 7.0 months for patients with CTC < 5 and ≥ 5, respectively; P < 0.001). Conversely, in patients with human epidermal growth factor receptor-2-overexpressed/amplified tumors receiving trastuzumab or lapatinib, the baseline CTC count was not prognostic (median progression-free survival 14.5 months for patients with CTC < 5 and 16.1 months for those with CTC ≥ 5; P = 0.947). Furthermore, in patients with human epidermal growth factor receptor-2 normal tumors, a baseline CTC count ≥ 5 identified subjects who derived benefit from more aggressive treatments, including combination chemotherapy and chemotherapy plus bevacizumab. This analysis suggests that the prognostic information provided by CTC count may be useful in patient stratifications and therapeutic selection, particularly in the group with positive CTCs, in which various therapeutic choices may procure differential palliative benefit. INTRODUCTION: Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the prognostic impact of CTCs according to different first-line systemic treatments, and explored their potential predictive value in MBC patients. METHODS: We retrospectively evaluated 235 newly diagnosed MBC patients, treated at the University of Texas MD Anderson Cancer Center. All patients had a baseline CTC assessment performed with CellSearch®. Progression-free survival and overall survival were compared with the log-rank test between groups, according to CTC count (< 5 vs. ≥ 5) and type of systemic therapy. We further explored the predictive value of baseline CTCs in patients receiving different treatments. RESULTS: At a median follow-up of 18 months, the CTC count was confirmed to be a robust prognostic marker in the overall population (median progression-free survival 12.0 and 7.0 months for patients with CTC < 5 and ≥ 5, respectively; P < 0.001). Conversely, in patients with human epidermal growth factor receptor-2-overexpressed/amplified tumors receiving trastuzumab or lapatinib, the baseline CTC count was not prognostic (median progression-free survival 14.5 months for patients with CTC < 5 and 16.1 months for those with CTC ≥ 5; P = 0.947). Furthermore, in patients with human epidermal growth factor receptor-2 normal tumors, a baseline CTC count ≥ 5 identified subjects who derived benefit from more aggressive treatments, including combination chemotherapy and chemotherapy plus bevacizumab. CONCLUSIONS: This analysis suggests that the prognostic information provided by CTC count may be useful in patient stratifications and therapeutic selection, particularly in the group with positive CTCs, in which various therapeutic choices may procure differential palliative benefit. Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the prognostic impact of CTCs according to different first-line systemic treatments, and explored their potential predictive value in MBC patients. We retrospectively evaluated 235 newly diagnosed MBC patients, treated at the University of Texas MD Anderson Cancer Center. All patients had a baseline CTC assessment performed with CellSearch.sup.[R].sup.. Progression-free survival and overall survival were compared with the log-rank test between groups, according to CTC count ([less than] 5 vs. [greater than or equal to] 5) and type of systemic therapy. We further explored the predictive value of baseline CTCs in patients receiving different treatments. At a median follow-up of 18 months, the CTC count was confirmed to be a robust prognostic marker in the overall population (median progression-free survival 12.0 and 7.0 months for patients with CTC [less than] 5 and [greater than or equal to] 5, respectively; P [less than] 0.001). Conversely, in patients with human epidermal growth factor receptor-2-overexpressed/amplified tumors receiving trastuzumab or lapatinib, the baseline CTC count was not prognostic (median progression-free survival 14.5 months for patients with CTC [less than] 5 and 16.1 months for those with CTC [greater than or equal to] 5; P = 0.947). Furthermore, in patients with human epidermal growth factor receptor-2 normal tumors, a baseline CTC count [greater than or equal to] 5 identified subjects who derived benefit from more aggressive treatments, including combination chemotherapy and chemotherapy plus bevacizumab. This analysis suggests that the prognostic information provided by CTC count may be useful in patient stratifications and therapeutic selection, particularly in the group with positive CTCs, in which various therapeutic choices may procure differential palliative benefit. |
| ArticleNumber | R67 |
| Audience | Academic |
| Author | De Laurentiis, Michelino De Placido, Sabino Hess, Kenneth R Giordano, Antonio Jackson, Summer Valero, Vicente Alvarez, Ricardo H Hortobagyi, Gabriel N Handy, Beverly C Reuben, James M Giuliano, Mario Mego, Michal De Giorgi, Ugo Ueno, Naoto T Cristofanilli, Massimo |
| AuthorAffiliation | 6 Currently: Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Via Maroncelli 40, 47014 Meldola (FC), Italy 9 Department of Medical Oncology, Fox Chase Medical Center, 333 Cottman Avenue, Rm 315, Philadelphia, PA 19111-2497, USA 1 Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA 8 Laboratory Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA 2 Department of Molecular and Clinical Oncology and Endocrinology, University of Naples Federico II, via Pansini 5, 80131 Naples, Italy 7 Currently: Department of Medical Oncology, School of Medicine, Comenius University, Klenova 1, Bratislava 833 10, Slovakia 5 Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA 3 Currently: Breast Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA 4 Breast Medical |
| AuthorAffiliation_xml | – name: 5 Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA – name: 9 Department of Medical Oncology, Fox Chase Medical Center, 333 Cottman Avenue, Rm 315, Philadelphia, PA 19111-2497, USA – name: 1 Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA – name: 2 Department of Molecular and Clinical Oncology and Endocrinology, University of Naples Federico II, via Pansini 5, 80131 Naples, Italy – name: 3 Currently: Breast Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA – name: 4 Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA – name: 6 Currently: Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Via Maroncelli 40, 47014 Meldola (FC), Italy – name: 7 Currently: Department of Medical Oncology, School of Medicine, Comenius University, Klenova 1, Bratislava 833 10, Slovakia – name: 8 Laboratory Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA |
| Author_xml | – sequence: 1 givenname: Mario surname: Giuliano fullname: Giuliano, Mario organization: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Department of Molecular and Clinical Oncology and Endocrinology, University of Naples Federico II, Breast Center, Baylor College of Medicine – sequence: 2 givenname: Antonio surname: Giordano fullname: Giordano, Antonio organization: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Department of Molecular and Clinical Oncology and Endocrinology, University of Naples Federico II – sequence: 3 givenname: Summer surname: Jackson fullname: Jackson, Summer organization: Breast Medical Oncology, The University of Texas MD Anderson Cancer Center – sequence: 4 givenname: Kenneth R surname: Hess fullname: Hess, Kenneth R organization: Department of Biostatistics, The University of Texas MD Anderson Cancer Center – sequence: 5 givenname: Ugo surname: De Giorgi fullname: De Giorgi, Ugo organization: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori – sequence: 6 givenname: Michal surname: Mego fullname: Mego, Michal organization: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Department of Medical Oncology, School of Medicine, Comenius University – sequence: 7 givenname: Beverly C surname: Handy fullname: Handy, Beverly C organization: Laboratory Medicine, The University of Texas MD Anderson Cancer Center – sequence: 8 givenname: Naoto T surname: Ueno fullname: Ueno, Naoto T organization: Breast Medical Oncology, The University of Texas MD Anderson Cancer Center – sequence: 9 givenname: Ricardo H surname: Alvarez fullname: Alvarez, Ricardo H organization: Breast Medical Oncology, The University of Texas MD Anderson Cancer Center – sequence: 10 givenname: Michelino surname: De Laurentiis fullname: De Laurentiis, Michelino organization: Department of Molecular and Clinical Oncology and Endocrinology, University of Naples Federico II – sequence: 11 givenname: Sabino surname: De Placido fullname: De Placido, Sabino organization: Department of Molecular and Clinical Oncology and Endocrinology, University of Naples Federico II – sequence: 12 givenname: Vicente surname: Valero fullname: Valero, Vicente organization: Breast Medical Oncology, The University of Texas MD Anderson Cancer Center – sequence: 13 givenname: Gabriel N surname: Hortobagyi fullname: Hortobagyi, Gabriel N organization: Breast Medical Oncology, The University of Texas MD Anderson Cancer Center – sequence: 14 givenname: James M surname: Reuben fullname: Reuben, James M organization: Department of Hematopathology, The University of Texas MD Anderson Cancer Center – sequence: 15 givenname: Massimo surname: Cristofanilli fullname: Cristofanilli, Massimo email: Massimo.Cristofanilli@fccc.edu organization: Department of Medical Oncology, Fox Chase Medical Center |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/21699723$$D View this record in MEDLINE/PubMed |
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| Snippet | Introduction
Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the... Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the prognostic impact... Introduction Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the... INTRODUCTION: Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the... |
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| SubjectTerms | Adult Aged Aged, 80 and over Antibodies, Monoclonal, Humanized - therapeutic use Bevacizumab Biomarkers, Tumor - blood Biomedical and Life Sciences Biomedicine Breast cancer Breast Neoplasms - drug therapy Breast Neoplasms - pathology Cancer Research Care and treatment Cell Line, Tumor Cells, Cultured Development and progression Diagnosis Disease Progression Drug therapy, Combination Female Health aspects Humans Metastasis Middle Aged Neoplastic Cells, Circulating Oncology Physiological aspects Predictive Value of Tests Prognosis Quinazolines - therapeutic use Receptor, Epidermal Growth Factor - biosynthesis Research Article Surgical Oncology Trastuzumab |
| Title | Circulating tumor cells as prognostic and predictive markers in metastatic breast cancer patients receiving first-line systemic treatment |
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