First-Line Doublet Chemotherapy for Metastatic Triple-Negative Breast Cancer: Circulating Tumor Cell Analysis of the tnAcity Trial
| Autor: | Wolfgang Janni, Denise A. Yardley, Vassilis Georgoulias, Nadia Harbeck, Xin Wei, Minetta C. Liu, Robert Beck, Desmond McGovern |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Chemotherapy Circulating Tumor Cell Analysis business.industry medicine.medical_treatment medicine.disease Metastatic breast cancer Gemcitabine Carboplatin 03 medical and health sciences chemistry.chemical_compound 030104 developmental biology 0302 clinical medicine Breast cancer Circulating tumor cell chemistry 030220 oncology & carcinogenesis Internal medicine medicine business Triple-negative breast cancer medicine.drug |
| Zdroj: | Cancer Management and Research. 11:10427-10433 |
| ISSN: | 1179-1322 |
| DOI: | 10.2147/cmar.s208712 |
| Popis: | Purpose Circulating tumor cells (CTCs) are prognostic biomarkers in metastatic breast cancer, but their role in predicting treatment outcomes in metastatic triple-negative breast cancer (mTNBC) is less clear. The tnAcity trial demonstrated a significant progression-free survival (PFS) benefit with nab-paclitaxel (nab-P)/carboplatin (C) over nab-P/gemcitabine (G) or G/C in patients with mTNBC. We assessed the correlation between CTC dynamics and clinical benefit in all patients and by treatment arm. Methods CTC enumeration, performed using CELLSEARCH technology (Menarini Silicon Biosystems, Huntingdon Valley, PA, USA), was a prespecified exploratory endpoint in the tnAcity trial. Patients with TNBC were categorized based on pre- and post-treatment CTC levels: Group 1 (+ + +; elevated CTCs at baseline and postbaseline), Group 2 (+ ± ±; CTCs elevated at baseline and cleared postbaseline [cycle 3 and/or cycle 5]), or Group 3 (-; no CTCs detected at baseline). The baseline cutoff was ≥1 CTC/7.5 mL for the main analysis; cutoffs of ≥2 and ≥5 CTCs were used for supporting analyses. Results The main analysis included 126 patients (Group 1, n = 24; Group 2, n = 54; and Group 3, n = 48). The median PFS was longer in Group 2 vs Group 1 (8.5 vs 4.7 months; HR, 0.30 [95% CI, 0.17-0.54]). These results were supported by the ≥2- and ≥5-CTC cutoff analyses. The median overall survival rates were 17.8, 16.0, and 9.8 months in Groups 2, 3, and 1, respectively. The overall response rates were 79.6%, 43.8%, and 29.2%, respectively. A numerically higher percentage of patients had CTC clearance during nab-P/C treatment vs nab-P/G or G/C. Conclusion Efficacy outcomes trended positively with chemotherapy-induced elimination of CTCs, suggesting that CTC clearance may predict the chemosensitivity of mTNBC tumors. Trial registration EudraCT Number: 2013-000113-20; ClinicalTrials.gov number: NCT01881230. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|