Single circulating tumor cell detection and overall survival in nonmetastatic breast cancer
| Autor: | Claire Mathiot, Suzette Delaloge, J-Y Pierga, E. Brain, Michel Marty, François-Clément Bidard, sylvie giachetti, P. de Cremoux |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Oncology medicine.medical_specialty Time Factors medicine.medical_treatment Breast Neoplasms Cell Separation Docetaxel Antibodies Monoclonal Humanized Metastasis Young Adult Circulating tumor cell Breast cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Neoplasm Metastasis Cyclophosphamide Early Detection of Cancer Neoadjuvant therapy Aged Epirubicin Sulfonamides business.industry Carcinoma Antibodies Monoclonal Cancer Hematology Middle Aged Trastuzumab Neoplastic Cells Circulating medicine.disease Survival Analysis Chemotherapy regimen Neoadjuvant Therapy Celecoxib Pyrazoles Female Taxoids Breast disease business medicine.drug |
| Zdroj: | Annals of Oncology. 21:729-733 |
| ISSN: | 0923-7534 |
| DOI: | 10.1093/annonc/mdp391 |
| Popis: | Background Circulation of cancer cells in the blood is a mandatory step for metastasis, but circulating tumor cells (CTC) have a low metastatic efficiency in preclinical animal models. In this prospective study, we reported the clinical outcome of nonmetastatic breast cancer patients according to CTC detection. Patients and methods In 115 nonmetastatic patients diagnosed with large operable or locally advanced breast cancer, we prospectively detected CTC using the CellSearch system before and after neoadjuvant chemotherapy in a phase II trial (REMAGUS02). Results At baseline, 23% of patients were CTC positive, but only 10% had >1 CTC/7.5 ml of blood. After a median follow-up of 36 months, CTC detection before chemotherapy was an independent prognostic factor for both distant metastasis-free survival [DMFS; P = 0.01, relative risk (RR) = 5.0, 95% confidence interval (CI) 1.4–17] and overall survival (OS; P = 0.007, RR = 9, 95% CI 1.8–45). CTC detection after chemotherapy was of less significance (P = 0.07 and 0.09, respectively). Moreover, CTC detection showed interesting characteristics as an individual predictive test for metastatic relapses (sensibility 55%, specificity 81%, and global accuracy 77%). Conclusions Detection of ≥1 CTC/7.5 ml before neoadjuvant chemotherapy can accurately predict OS. Our findings may change the clinical management of nonmetastatic breast cancer and indicate that the metastatic efficiency of CTC could be higher than previously reported. |
| Databáze: | OpenAIRE |
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