Circulating tumor cells as prognostic and predictive markers in metastatic breast cancer patients receiving first-line systemic treatment.
Circulating tumor cells as prognostic and predictive markers in metastatic breast cancer patients receiving first-line systemic treatment.
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DOI：
10.1186/bcr2907
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发表时间：
2011-06-15
期刊：
影响因子：
--
通讯作者：
Cristofanilli M
中科院分区：
文献类型：
--
作者：
Giuliano M;Giordano A;Jackson S;Hess KR;De Giorgi U;Mego M;Handy BC;Ueno NT;Alvarez RH;De Laurentiis M;De Placido S;Valero V;Hortobagyi GN;Reuben JM;Cristofanilli M
循环肿瘤细胞（CTC）是转移性乳腺癌（MBC）患者结局的独立预测因子。我们根据不同的一线系统治疗评估CTC的预后影响，并探讨其在MBC患者中的潜在预测价值。我们回顾性评估了235例新诊断的MBC患者，他们在德克萨斯大学MD安德森癌症中心接受治疗。所有患者都具有用CellSearch®进行的基线CTC评估。根据CTC计数（< 5 vs. ≥ 5）和全身治疗类型，采用对数秩检验比较各组间的无进展生存期和总生存期。我们进一步探讨了接受不同治疗的患者中基线CTC的预测价值。在中位随访18个月时，CTC计数被证实是总体人群中一个可靠的预后标志物（CTC < 5和≥ 5的患者中位无进展生存期分别为12.0和7.0个月; P < 0.001）。相反，在接受曲妥珠单抗或拉帕替尼治疗的人表皮生长因子受体2过表达/扩增肿瘤患者中，基线CTC计数无预后意义（CTC < 5的患者中位无进展生存期为14.5个月，CTC ≥ 5的患者中位无进展生存期为16.1个月; P = 0.947）。此外，在人表皮生长因子受体2正常肿瘤患者中，基线CTC计数≥ 5的受试者可从更积极的治疗中获益，包括联合化疗和化疗+贝伐珠单抗。该分析表明，CTC计数提供的预后信息可能有助于患者分层和治疗选择，特别是在CTC阳性组中，其中各种治疗选择可能获得不同的姑息性获益。
Circulating tumor cells (CTCs) represent an independent predictor of outcome in patients with metastatic breast cancer (MBC). We assessed the prognostic impact of CTCs according to different first-line systemic treatments, and explored their potential predictive value in MBC patients. We retrospectively evaluated 235 newly diagnosed MBC patients, treated at the University of Texas MD Anderson Cancer Center. All patients had a baseline CTC assessment performed with CellSearch®. Progression-free survival and overall survival were compared with the log-rank test between groups, according to CTC count (< 5 vs. ≥ 5) and type of systemic therapy. We further explored the predictive value of baseline CTCs in patients receiving different treatments. At a median follow-up of 18 months, the CTC count was confirmed to be a robust prognostic marker in the overall population (median progression-free survival 12.0 and 7.0 months for patients with CTC < 5 and ≥ 5, respectively; P < 0.001). Conversely, in patients with human epidermal growth factor receptor-2-overexpressed/amplified tumors receiving trastuzumab or lapatinib, the baseline CTC count was not prognostic (median progression-free survival 14.5 months for patients with CTC < 5 and 16.1 months for those with CTC ≥ 5; P = 0.947). Furthermore, in patients with human epidermal growth factor receptor-2 normal tumors, a baseline CTC count ≥ 5 identified subjects who derived benefit from more aggressive treatments, including combination chemotherapy and chemotherapy plus bevacizumab. This analysis suggests that the prognostic information provided by CTC count may be useful in patient stratifications and therapeutic selection, particularly in the group with positive CTCs, in which various therapeutic choices may procure differential palliative benefit.
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影响因子：
45.3
作者：
Cristofanilli, M;Hayes, DF;Terstappen, LWMM
通讯作者：
Terstappen, LWMM
影响因子：
158.5
作者：
Cristofanilli, M;Budd, GT;Hayes, DF
通讯作者：
Hayes, DF
影响因子：
11.5
作者：
Hayes, Daniel F.;Cristofanilli, Massimo;Terstappen, Leon W. W. M.
通讯作者：
Terstappen, Leon W. W. M.
影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
11.5
作者：
Riethdorf, Sabine;Mueller, Volkmar;Pantel, Klaus
通讯作者：
Pantel, Klaus