Prognostic Impact of Circulating Tumor Cells for Breast Cancer Patients Treated in the Neoadjuvant "Geparquattro" Trial.

Autor:	Riethdorf S; Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. sriethdorf@uke.de., Müller V; Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Loibl S; German Breast Group, Neu Isenburg, Germany., Nekljudova V; German Breast Group, Neu Isenburg, Germany., Weber K; German Breast Group, Neu Isenburg, Germany., Huober J; Department of Gynecology and Obstetrics, University Medical Center, Ulm, Germany., Fehm T; Department of Obstetrics and Gynecology, University Medical Center, Düsseldorf, Germany., Schrader I; Gynecologic/Oncological Office, Hannover, Germany., Hilfrich J; Eilenriede-Hospital, Hannover, Germany., Holms F; Department of Obstetrics and Gynecology, St. Barbara-Klinik, Hamm-Heessen, Germany., Tesch H; Oncology Bethanien, Frankfurt, Germany., Schem C; Department of Gynecology and Obstetrics, University Medical Center, Kiel, Germany., von Minckwitz G; German Breast Group, Neu Isenburg, Germany., Untch M; Department of Obstetrics and Gynecology, Heliosklinik Buch, Berlin, Germany., Pantel K; Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jazyk:	angličtina
Zdroj:	Clinical cancer research : an official journal of the American Association for Cancer Research [Clin Cancer Res] 2017 Sep 15; Vol. 23 (18), pp. 5384-5393. Date of Electronic Publication: 2017 Jul 05.
DOI:	10.1158/1078-0432.CCR-17-0255
Abstrakt:	Purpose: This study aimed to evaluate the prognostic impact of circulating tumor cells (CTC) detected in patients with operable or locally advanced breast cancer before and after neoadjuvant therapy (NT) within the clinical trial GeparQuattro. Experimental Design: Data on CTCs enumerated with the CellSearch system were available for 213 and 207 patients before and after NT, respectively. Associations of CTCs with disease-free survival (DFS) and overall survival (OS) were analyzed by nonparametric Kaplan-Meier estimates and parametric Cox regression. Results: After a median follow-up of 67.1 months, the detection of ≥1 CTC/7.5 mL and ≥2 CTCs/7.5 mL before NT was associated with reduced DFS ( P = 0.031 and P < 0.0001, respectively) and OS ( P = 0.0057 and P < 0.0001, respectively), whereas CTCs detected after NT did not correlate with DFS or OS. In parametric univariate and multivariate Cox models, ≥1 CTC/7.5 mL, ≥2 CTCs/7.5 mL, and absolute CTC numbers before NT revealed to be independent prognostic parameters of DFS and OS. CTC-negative patients with pathologic complete response (pCR) exhibited the best prognosis, whereas those with CTCs and less tumor response were at high risk of tumor relapse. In HER2 (ERBB2)-positive and triple-negative patients, ≥2 CTCs/7.5 mL detected before NT also were significantly associated with worse DFS and OS. Conclusions: Detection of CTCs before NT is an independent prognostic factor of impaired clinical outcome, and combined with pCR, it could be helpful to stratify breast cancer patients for therapeutic interventions. Clin Cancer Res; 23(18); 5384-93. ©2017 AACR . (©2017 American Association for Cancer Research.)
Databáze:	MEDLINE
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