Detection and HER2 expression of circulating tumor cells: prospective monitoring in breast cancer patients treated in the neoadjuvant GeparQuattro trial
| Autor: | Holger Eidtmann, Hans Tesch, Sibylle Loibl, Michael Untch, Liling Zhang, Jörn Hilfrich, Jens Huober, Martina Komor, Thomas Rau, Tanja Fehm, Frank Holms, Volkmar Müller, Gunter von Minckwitz, Marc Roller, Klaus Pantel, Iris Schrader, Sabine Riethdorf |
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| Rok vydání: | 2010 |
| Předmět: |
Oncology
Cancer Research Pathology Time Factors Receptor ErbB-2 medicine.medical_treatment Fluorescent Antibody Technique Docetaxel Deoxycytidine Circulating tumor cell hemic and lymphatic diseases Antineoplastic Combined Chemotherapy Protocols Prospective Studies skin and connective tissue diseases Neoadjuvant therapy Antibodies Monoclonal Middle Aged Neoplastic Cells Circulating Primary tumor Neoadjuvant Therapy Treatment Outcome Chemotherapy Adjuvant Taxoids Breast disease Fluorouracil medicine.drug Epirubicin medicine.medical_specialty education Breast Neoplasms Antibodies Monoclonal Humanized Drug Administration Schedule Breast cancer Internal medicine Cell Line Tumor medicine Humans neoplasms Cyclophosphamide Capecitabine Neoplasm Staging business.industry Cancer Trastuzumab medicine.disease digestive system diseases business Follow-Up Studies |
| Zdroj: | Clinical cancer research : an official journal of the American Association for Cancer Research. 16(9) |
| ISSN: | 1557-3265 |
| Popis: | Purpose: This study was aimed at detecting and characterizing circulating tumor cells (CTC) before and after neoadjuvant therapy (NT) in the peripheral blood of patients with breast cancer. Experimental Design: The clinical trial GeparQuattro incorporated NT approaches (epirubicin/cyclophosphamide prior to randomization to docetaxel alone, docetaxel in combination with capecitabine, or docetaxel followed by capecitabine) and additional trastuzumab treatment for patients with HER2-positive tumors. We used the Food and Drug Administration–approved CellSearch system for CTC detection and evaluation of HER2 expression and developed HER2 immunoscoring for CTC. Results: We detected ≥1 CTC/7.5 mL in 46 of 213 patients (21.6%) before NT and in 22 of 207 patients (10.6%) after NT (P = 0.002). Twenty (15.0%) initially CTC-positive cases were CTC-negative after NT, whereas 11 (8.3%) cases were CTC-positive after NT, although no CTC could be found before NT. CTC detection did not correlate with primary tumor characteristics. Furthermore, there was no association between tumor response to NT and CTC detection. HER2-overexpressing CTC were observed in 14 of 58 CTC-positive patients (24.1%), including 8 patients with HER2-negative primary tumors and 3 patients after trastuzumab treatment. CTC scored HER2-negative or weakly HER2-positive before or after NT were present in 11 of 21 patients with HER2-positive primary tumors. HER2 overexpression on CTC was restricted to ductal carcinomas and associated with high tumor stage (P = 0.002). Conclusion: CTC number was low in patients with primary breast cancer. The decrease in CTC incidence during treatment was not correlated with standard clinical characteristics and primary tumor response. Information on the HER2 status of CTC might be helpful for stratification and monitoring of HER2-directed therapies. Clin Cancer Res; 16(9); 2634–45. ©2010 AACR. |
| Databáze: | OpenAIRE |
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