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Role of Circulating Tumor Cells in Determining Prognosis in Metastatic Breast CancerFunding None.
Background Circulating tumor cells (CTCs) in the peripheral blood may play a major role in the metastatic spread of breast cancer. This study was conducted to assess the role of CTCs to determine the prognosis in terms of survival in metastatic breast cancer patients.
Methods This prospective study of 36 patients was conducted at the Hospital from April 2016 to May 2018. Details of each patient related to the demographic profile, tumor type, treatment, and follow-up information were recorded. The number of CTCs in the peripheral blood was measured by Celsee PREP 400 sample processing system and Celsee Analyzer imaging station.
Results There was a positive correlation between the number of site of metastasis with number of CTCs (p-value < 0.001). In the patients with clinical/partial response, a significant reduction in the number of CTCs after 1 month of therapy was observed (p-value = 0.003). When the number of CTCs at baseline and 6 months were compared with the positron emission tomography response at 6 months, a statistically significant difference in CTCs in patients having partial response after 6 months was observed (p-value = 0.001). On comparison with the responder groups, a statistically significant reduction in CTCs at baseline and 6 months was observed (p-value = 0.001). Patients with CTCs less than 5 and more than or equal to 5 after 1 month of treatment had a mean progression-free survival of 11.1 months and 7.5 months (p-value = 0.04) and a mean overall survival of 11.6 and 9.6 months (p-value = 0.08), respectively.
Conclusion Assessment of CTCs provides a more quantifiable response than radiographic evaluation and at a much earlier time point and is also a better predictor of survival.
This study was approved by the Institutional Review Board.
Written informed consent was taken from all the patients before the initiation of this study.
Article published online:
22 August 2022
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- 1 Agarwal G, Ramakant P. Breast cancer care in India: the current scenario and the challenges for the future. Breast Care (Basel) 2008; 3 (01) 21-27
- 2 Schmidt M, Fasching PA, Beckmann MW, Kölbl H. Biomarkers in breast cancer - an update. Geburtshilfe Frauenheilkd 2012; 72 (09) 819-832
- 3 Melcher C, Scholz C, Jäger B, Hagenbeck C, Rack B, Janni W. Breast cancer: state of the art and new findings. Geburtshilfe Frauenheilkd 2012; 72 (03) 215-224
- 4 Park Y, Kitahara T, Urita T, Yoshida Y, Kato R. Expected clinical applications of circulating tumor cells in breast cancer. World J Clin Oncol 2011; 2 (08) 303-310
- 5 Mikulová V, Kološtová K, Zima T. Methods for detection of circulating tumour cells and their clinical value in cancer patients. Folia Biol (Praha) 2011; 57 (04) 151-161
- 6 Mostert B, Sieuwerts AM, Martens JWM, Sleijfer S. Diagnostic applications of cell-free and circulating tumor cell-associated miRNAs in cancer patients. Expert Rev Mol Diagn 2011; 11 (03) 259-275
- 7 Deng G, Herrler M, Burgess D, Manna E, Krag D, Burke JF. Enrichment with anti-cytokeratin alone or combined with anti-EpCAM antibodies significantly increases the sensitivity for circulating tumor cell detection in metastatic breast cancer patients. Breast Cancer Res 2008; 10 (04) R69
- 8 Ignatiadis M, Georgoulias V, Mavroudis D. Circulating tumor cells in breast cancer. Curr Opin Obstet Gynecol 2008; 20 (01) 55-60
- 9 Cristofanilli M, Budd GT, Ellis MJ. et al. Circulating tumor cells, disease progression, and survival in metastatic breast cancer. N Engl J Med 2004; 351 (08) 781-791
- 10 Balic M, Lin H, Williams A, Datar RH, Cote RJ. Progress in circulating tumor cell capture and analysis: implications for cancer management. Expert Rev Mol Diagn 2012; 12 (03) 303-312
- 11 Lianidou ES, Markou A. Circulating tumor cells in breast cancer: detection systems, molecular characterization, and future challenges. Clin Chem 2011; 57 (09) 1242-1255
- 12 Sun YF, Yang XR, Zhou J, Qiu SJ, Fan J, Xu Y. Circulating tumor cells: advances in detection methods, biological issues, and clinical relevance. J Cancer Res Clin Oncol 2011; 137 (08) 1151-1173
- 13 Reinholz MM, Kitzmann KA, Tenner K. et al. Cytokeratin-19 and mammaglobin gene expression in circulating tumor cells from metastatic breast cancer patients enrolled in North Central Cancer Treatment Group trials, N0234/336/436/437. Clin Cancer Res 2011; 17 (22) 7183-7193
- 14 Riahi R, Gogoi P, Sepehri S. et al. A novel microchannel-based device to capture and analyze circulating tumor cells (CTCs) of breast cancer. Int J Oncol 2014; 44 (06) 1870-1878
- 15 Edge S, Byrd DR, Compton CC, Fritz AG, Greene F, Trotti A. AJCC Cancer Staging Manual. 7th edition.. New York: Springer; 2010: 347-376
- 16 Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53: 457-481
- 17 Tokudome N, Ito Y, Takahashi S. et al. Detection of circulating tumor cells in peripheral blood of heavily treated metastatic breast cancer patients. Breast Cancer 2011; 18 (03) 195-202
- 18 Fehm T, Müller V, Aktas B. et al. HER2 status of circulating tumor cells in patients with metastatic breast cancer: a prospective, multicenter trial. Breast Cancer Res Treat 2010; 124 (02) 403-412
- 19 Hayes DF, Smerage J. Is there a role for circulating tumor cells in the management of breast cancer?. Clin Cancer Res 2008; 14 (12) 3646-3650
- 20 Thakur NA, Humne AY, Godale LB. Delay in presentation to the hospital and factors affecting it in breast cancer patients attending tertiary care center in Central India. Indian J Cancer 2015; 52 (01) 102-105
- 21 Budd GT, Cristofanilli M, Ellis MJ. et al. Circulating tumor cells versus imaging–predicting overall survival in metastatic breast cancer. Clin Cancer Res 2006; 12 (21) 6403-6409
- 22 Harbeck N, Penault-Llorca F, Cortes J. et al. Breast cancer. Nat Rev Dis Primers 2019; 5 (01) 66
- 23 Krebs MG, Hou JM, Ward TH, Blackhall FH, Dive C. Circulating tumour cells: their utility in cancer management and predicting outcomes. Ther Adv Med Oncol 2010; 2 (06) 351-365