Circulating tumor cells in immunohistochemical subtypes of metastatic breast cancer: lack of prediction in HER2-positive disease treated with targeted therapy
Circulating tumor cells in immunohistochemical subtypes of metastatic breast cancer: lack of prediction in HER2-positive disease treated with targeted therapy
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DOI：
10.1093/annonc/mdr434
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发表时间：
2012-05-01
影响因子：
50.5
通讯作者：
Cristofanilli, M.
中科院分区：
文献类型：
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作者：
Giordano, A.;Giuliano, M.;Cristofanilli, M.
循环肿瘤细胞（CTCs）与转移性乳腺癌（MBC）的不良预后相关。我们假设CTCs与疾病亚型之间的关系将有助于更好地理解MBC的临床和生物学行为。我们回顾性分析了517例在单一机构接受治疗的MBC患者。在开始新疗法时，用免疫组织化学（IHC）或荧光原位杂交分析原发肿瘤的亚型，用CellSearch（(R)）列举CTCs。确定每个IHC亚型的总生存期（OS）和无进展生存期。在24.6个月的中位随访中，517例患者中有276例（53%）死亡。CTCs < 5和>= 5患者的中位OS分别为32.4和18.3个月（P < 0.001）。除HER2+患者外，ctc的预后价值与疾病亚型和疾病部位无关。在这项大型回顾性研究中，除了接受靶向治疗的HER2+患者外，ctc对所有MBC亚型的生存都有很强的预测作用。我们的研究结果清楚地证明了枚举MBC中ctc的价值，并强烈建议在HER2+患者亚群中有有趣的生物学意义，需要进一步探索。
Circulating tumor cells (CTCs) are associated with inferior prognosis in metastatic breast cancer (MBC). We hypothesized that the relationship between CTCs and disease subtype would provide a better understanding of the clinical and biologic behavior of MBC.We retrospectively analyzed 517 MBC patients treated at a single institution. Subtypes of primary tumors were analyzed by immunohistochemical (IHC) or fluorescent in situ hybridization analyses and CTCs were enumerated by CellSearch((R)) at starting a new therapy. Overall survival (OS) and progression-free survival durations for each IHC subtype were determined.At a median follow-up of 24.6 months, 276 of 517 (53%) patients had died. The median OS for patients with < 5 and >= 5 CTCs were 32.4 and 18.3 months, respectively (P < 0.001). Except in HER2+ patients, the prognostic value of CTCs was independent of disease subtype and disease site.In this large retrospective study, CTCs were strongly predictive of survival in all MBC subtypes except HER2+ patients who had been treated with targeted therapy. Our results clearly demonstrate the value of enumerating CTCs in MBC and strongly suggest an interesting biological implication in the HER2+ subset of patients that need to be further explored.