Circulating tumor cells at each follow-up time point during therapy of metastatic breast cancer patients predict progression-free and overall survival

被引:794
作者
Hayes, Daniel F.
Cristofanilli, Massimo
Budd, G. Thomas
Ellis, Matthew J.
Stopeck, Alison
Miller, M. Craig
Matera, Jeri
Allard, W. Jeffrey
Doyle, Gerald V.
Terstappen, Leon W. W. M.
机构
[1] Univ Michigan Hlth & Hosp Syst, Dept Internal Med, Ann Arbor, MI USA
[2] Univ Michigan Hlth & Hosp Syst, Ctr Comprehens Canc, Ann Arbor, MI USA
[3] Univ Texas, MD Anderson Canc Ctr, Dept Breast Med Oncol, Houston, TX 77030 USA
[4] Cleveland Clin Fdn, Dept Med, Cleveland, OH 44195 USA
[5] Washington Univ, Dept Med, St Louis, MO USA
[6] Univ Arizona, Arizona Canc Ctr, Dept Med, Tucson, AZ USA
[7] Immunicon Corp, Huntingdon Valley, PA USA
关键词
D O I
10.1158/1078-0432.CCR-05-2821
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 from each of the five blood draw time points were 7.0, 6.1, 5.6,7.0, and 6.0 months, respectively. 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 <5 CTC from the five blood draw time points was all >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.
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页码:4218 / 4224
页数:7
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