Changing levels of circulating tumor cells in monitoring chemotherapy response in patients with metastatic breast cancer.
ABSTRACT The detection of >5 circulating tumor cells (CTCs)/7.5 ml blood in patients being treated for metastatic breast cancer (MBC) has recently been shown to be predictive for therapy efficacy. The aim of this study was to investigate whether changing CTC levels during the course of chemotherapy treatment would also be useful in monitoring response to treatment.
CTC levels were determined in 58 MBC patients at the beginning and after 3 cycles of chemotherapy. Changes in CTC level (either negative CTCs (<5 CTCs/7.5 ml blood) turning positive, vice versa, or a change of ±25%) were correlated to radiologic Response Evaluation Criteria In Solid Tumors (RECIST) criteria, as well as serum CA 15-3 measurements, and were evaluated for their capability to predict survival.
Changing CTC levels significantly correlated with response to therapy as measured by radiologic RECIST criteria (p<0.001), and serum CA 15-3 level changes (p=0.017). Patients with decreasing CTC levels survived significantly longer than patients with increasing CTC levels (17.67±5.90 months versus 4.53±0.54 months, p<0.001).
The observation of changes in CTC level during the course of chemotherapy is useful in monitoring therapy efficacy and is correlated with overall survival. Further prospective trials should investigate the clinical usefulness of determining changes in CTC level during chemotherapy of MBC.
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ABSTRACT: To prospectively assess circulating tumor cell (CTC) status at baseline (CTCBL) and after one cycle of a new line of systemic therapy (CTC1C), and changes from CTCBL to CTC1C (CTC kinetics, CTCKIN) for their utility in predicting response, progression-free (PFS) and overall survival (OS) in metastatic breast cancer (MBC).BMC Cancer 07/2014; 14(1):512. DOI:10.1186/1471-2407-14-512 · 3.32 Impact Factor
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ABSTRACT: Isolierte Tumorzellen können sowohl im peripheren Blut als auch im Knochenmark (KM) von Patientinnen mit Mammakarzinom detektiert werden. Während der Nachweis von disseminierten Tumorzellen (DTZ) im Knochenmark von primären Mammakarzinompatientinnen einen unabhängigen Prognosefaktor (Level-I-Evidenz) darstellt, ist die prognostische Bedeutung von zirkulierenden Tumorzellen (ZTZ) im peripheren Blut in diesem Kollektiv noch nicht eindeutig geklärt. Im Beitrag werden die Relevanz von ZTZ beim primären wie beim metastasierten Mammakarzinom und die aktuelle Studienlage zu diesem Thema erläutert. Abstract Isolated tumor cells can be detected in peripheral blood and bone marrow of breast cancer patients. The prognostic significance of disseminated tumor cells (DTC) in bone marrow (BM) has been demonstrated in a large pooled analysis (level I evidence). Since BM biopsies are not well tolerated by many patients, evaluation of circulating tumor cells (CTC) in blood may represent an important alternative. Recent studies have indicated a prognostic significance of CTC in both the primary and metastatic setting. The evaluation of CTC may become one of the crucial markers for prediction of survival and therapy monitoring, and its characterization might enable specific targeting of minimal residual as well as metastatic disease. This report provides an overview of ongoing studies regarding CTC as well as the clinical relevance of CTC in primary and metastatic breast cancer.Der Gynäkologe 07/2012; 45(7):563-567. DOI:10.1007/s00129-012-3015-8
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ABSTRACT: The primary cause of tumor-related death in breast cancer (BC) is still represented by distant metastasization. The dissemination of tumor cells from the primary tumor to distant sites through bloodstream cannot be early detected by standard imaging methods. The enumeration of circulating tumor cells (CTCs) represents an effective prognostic and predictive biomarker, which is able to monitor efficacy of adjuvant therapies, detect early development of (micro)metastases and at last, assess therapeutic responses of advanced disease earlier than traditional imaging methods. Moreover, since repeated tissue biopsies are invasive, costly and not always feasible, the assessment of tumor characteristics on CTCs, by a peripheral blood sample as a ‘liquid biopsy’, represents an attractive opportunity. The implementation of molecular and genomic characterization of CTCs could contribute to improve the treatment selection and thus, to move toward more personalized treatments. This review describes the current state of the art on CTC detection strategies, the evidence to demonstrate their clinical validity, and their potential impact for both future clinical trial design and, decision-making process in our daily practice.