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01.10.2016 | Clinical trial

Impact of apoptotic circulating tumor cells (aCTC) in metastatic breast cancer

verfasst von: Thomas M. Deutsch, Sabine Riethdorf, Juliane Nees, Andreas D. Hartkopf, Birgitt Schönfisch, Christoph Domschke, Martin R. Sprick, Florian Schütz, Sara Y. Brucker, Stefan Stefanovic, Christof Sohn, Klaus Pantel, Andreas Trumpp, Andreas Schneeweiss, Markus Wallwiener

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 2/2016

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Abstract

Purpose

While intact circulating tumor cells (iCTC) have independent negative prognostic impact on patients with metastatic breast cancer (MBC), the prognostic relevance of apoptotic CTC (aCTC) has not been validated in larger patient cohorts. This study assessed aCTC and iCTC statuses at baseline (CTC_BL) and CTC kinetics (CTC_KIN) as changes from CTC_BL to one completed treatment cycle for their utility in predicting response, progression-free survival (PFS), and overall survival (OS) in MBC.

Methods

Status of iCTC and aCTC was prospectively assessed in 442 patients using the CellSearch™ system. Different cutoffs were analyzed both for iCTC and aCTC (≥5, ≥10, ≥25 and ≥50 CTC/7.5 ml). CTC_KIN were characterized by ≥25 % changes in CTC counts.

Results

Numbers of iCTC and aCTC at baseline correlated strongly (r = 0.7). For iCTC_BL positive patients, additional detection of aCTC_BL had a significant prognostic impact on OS (aCTC_BL positive 10.3 vs. aCTC_BL negative 16.4 months, p = 0.012). Worst prognosis for OS was observed in patients with ≥50 iCTC/7.5 ml and simultaneously detected aCTC. Determination of aCTC_KIN showed stronger discriminating power than iCTC_KIN, with higher PFS and OS for the group with decreasing CTCs (PFS 7.7 vs. 6.1; OS 22.2 vs. 16.4).

Conclusions

Intact and aCTC are predictive of outcome in MBC. Apoptotic CTC counts ≥ 5/7.5 ml in conjunction with iCTC at baseline have an independent unfavorable prognostic impact on OS. Decreasing aCTC_KIN at ≥ 5/7.5 ml in serial enumeration is associated with favorable outcome. Therefore, separate enumeration of iCTC and aCTC is useful in tailoring systemic treatment.

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Titel: Impact of apoptotic circulating tumor cells (aCTC) in metastatic breast cancer
verfasst von: Thomas M. Deutsch
Sabine Riethdorf
Juliane Nees
Andreas D. Hartkopf
Birgitt Schönfisch
Christoph Domschke
Martin R. Sprick
Florian Schütz
Sara Y. Brucker
Stefan Stefanovic
Christof Sohn
Klaus Pantel
Andreas Trumpp
Andreas Schneeweiss
Markus Wallwiener
Publikationsdatum: 01.10.2016
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 2/2016
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-016-3997-3

Springer Medizin

Impact of apoptotic circulating tumor cells (aCTC) in metastatic breast cancer