Variation of circulating tumor cell levels during treatment of metastatic breast cancer:: prognostic and therapeutic implications
Variation of circulating tumor cell levels during treatment of metastatic breast cancer:: prognostic and therapeutic implications
复制标题
DOI：
10.1093/annonc/mdm558
复制
发表时间：
2008-05-01
影响因子：
50.5
通讯作者：
Sandri, M. T.
中科院分区：
文献类型：
--
作者：
Nole, F.;Munzone, E.;Sandri, M. T.
背景：本研究旨在评估循环肿瘤细胞(CTCs)检测在晚期乳腺癌患者预后中的意义。患者和方法：我们检测了80例患者在开始新的治疗前、治疗后4周、8周、第一次临床评估时以及此后每隔2个月的CTC水平。使用CellSearch System(TM)检测CTCs。结果：49例患者在基线时有5个CTCs。在多变量分析中，CTC的基线数量与无进展生存率显著相关[风险比(HR)2.5；95%可信区间(CI)1.2-5.4]。最后一次抽血时CTCs=5的患者进展的风险是同一时间点CTCs为0-4的患者的5倍(HR 5.3；95%CI 2.8-10.4)。最后一次抽血中CTC升高或持续为5的患者与两次抽血中均为<；5的患者相比，进展的风险有统计学意义(HR 6.4；95%CI 2.8-14.6)。结论：CTCs基础值是一个预测预后的指标，治疗期间CTC水平的变化可能预示着临床疗效。在靶向治疗期间检测CTC水平可能会替代其他测量参数来进行反应评估。
Background: This study aimed to evaluate the prognostic significance of circulating tumor cells (CTCs) detection in advanced breast cancer patients.Patients and methods: We tested 80 patients for CTC levels before starting a new treatment and after 4, 8 weeks, at the first clinical evaluation and every 2 months thereafter. CTCs were detected using the CellSearch System (TM).Results: Forty-nine patients had >= 5 CTCs at baseline. At the multivariate analysis, baseline number of CTCs was significantly associated with progression-free survival [hazard ratio (HR) 2.5; 95% confidence interval (CI) 1.2-5.4]. The risk of progression for patients with CTCs >= 5 at last available blood draw was five times the risk of patients with 0-4 CTCs at the same time point (HR 5.3; 95% CI 2.8-10.4). Patients with rising or persistent >= 5 CTCs at last available blood draw showed a statistically significant higher risk of progression with respect to patients with < 5 CTCs at both blood draws (HR 6.4; 95% CI 2.8-14.6).Conclusion: CTCs basal value is a predictive indicator of prognosis and changes in CTC levels during therapy may indicate a clinical response. Testing CTC levels during targeted treatments might substitute other measurement parameters for response evaluation.