Circulating tumor cells at each follow-up time point during therapy of metastatic breast cancer patients predict progression-free and overall survival
Circulating tumor cells at each follow-up time point during therapy of metastatic breast cancer patients predict progression-free and overall survival
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DOI：
10.1158/1078-0432.ccr-05-2821
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发表时间：
2006-07-15
影响因子：
11.5
通讯作者：
Terstappen, Leon W. W. M.
中科院分区：
文献类型：
--
作者：
Hayes, Daniel F.;Cristofanilli, Massimo;Terstappen, Leon W. W. M.
目的：我们先前报道在177例转移性乳腺癌(MBC)患者中，基线和首次随访时7.5mL血中-gt；=5个循环肿瘤细胞(CTC)与不良的临床结局有关。在这项研究中，额外的随访数据和后续随访时的CTC水平被评估。实验设计：在开始新的疗程(基线)之前，以及开始治疗后的3到5，6到8，9到14，和15到20周，对177名MBC患者进行CTC计数。根据每次随访采血的日期计算无进展生存期(PFS)和总生存期(OS)。采用Kaplan-Meier曲线图和生存分析方法，以~gt；=5个CTCs/7.5毫升为阈值。结果：CTC=5的患者中位PFS时间显著缩短，分别为2.7、13、11.4、3.0和3.6个月。中位OS为18.5个月的患者。对于>；=5 CTC的患者，这些相同时间点的中位OS显著缩短：分别为10.9、6.3、6.3、6.6和6.7个月。治疗前和治疗后9至14周的中位PFS和OS时间差异有统计学意义。结论：在治疗过程中的任何时候检测到CTCs升高是MBC患者随后疾病快速进展和死亡的准确指示。
Purpose: We reported previously that >= 5 circulating tumor cells (CTC) in 7.5 mL blood at baseline and at first follow-up in 177 patients with metastatic breast cancer (MBC) were associated with poor clinical outcome. In this study, additional follow-up data and CTC levels at subsequent follow-up visits were evaluated.Experimental Design: CTCs were enumerated in 177 MBC patients before the initiation of a new course of therapy (baseline) and 3 to 5, 6 to 8, 9 to 14, and 15 to 20 weeks after the initiation of therapy. Progression-free survival (PFS) and overall survival (OS) times were calculated from the dates of each follow-up blood draw. Kaplan-Meier plots and survival analyses were done using a threshold of >= 5 CTCs/7.5 mL at each blood draw.Results: Median PFS times for patients with = 5 CTC, median PFS from these same time points was significantly shorter: 2.7,13,11.4, 3.0, and 3.6 months, respectively. Median OS for patients with 18.5 months. For patients with >= 5 CTC, median OS from these same time points was significantly shorter: 10.9, 6.3, 6.3, 6.6, and 6.7 months, respectively. Median PFS and OS times at baseline and up to 9 to 14 weeks after the initiation of therapy were statistically significantly different.Conclusions: Detection of elevated CTCs at any time during therapy is an accurate indication of subsequent rapid disease progression and mortality for MBC patients.