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Circulating tumor cells predict survival, recurrence in early-stage breast cancer
The presence of one or more circulating tumor cells can predict early recurrence and decreased OS in patients with early-stage breast cancer, according to results of a prospective study.
Axillary lymph node status currently is the best predictor of outcome in operable breast cancer, but the number of circulating tumor cells in the blood before treatment has shown to be a predictor of PFS and OS in patients with metastatic breast cancer, according to researchers.
To further evaluate this, Anthony Lucci, MD, professor in the department of surgical oncology at The University of Texas MD Anderson Cancer Center, and colleagues collected data from 302 chemotherapy-naive patients with stage I to III breast cancer at the time they underwent surgery for their primary tumor.
Data collection occurred from February 2005 to December 2010. The mean age of patients was 54 years.
Patients were excluded if they had bilateral breast cancer or any other malignancy within 5 years of their current breast cancer diagnosis.
The researchers performed basic blood tests to determine the number of tumor cells circulating in the patients’ blood. The researchers correlated their findings with standard tumor characteristics, including size and grade, ER and PR status, and HER-2 and axillary lymph node status.
Median follow-up was 35 months.
Lucci and researchers identified one or more circulating tumor cells in 73 (24%) of the 302 patients.
The detection of one or more circulating tumor cells predicted decreased PFS at 2 years (HR=4.62, 95% CI 1.79-11.9), as well as decreased OS (HR=4.04; 95% CI, 1.28-12.8), according to study results.
Of the 73 patients identified to have one or more circulating tumor cells, 11 (15%) experienced a relapse.
Of the 229 patients who did not have one or more circulating tumor cells, seven (3%) had a relapse.
Seven patients (10%) with one or more circulating tumor cells died compared with five patients (2%) who had no circulating tumor cells.
The more circulating tumor cells the breast cancer patients had in their bloodstream, the greater the risk for relapse or death, the study found.
“Remarkably, even with a relative short follow-up, there were significantly worse outcomes in patients with one or more circulating tumor cells,” Lucci and colleagues wrote.
No primary tumor characteristic predicted the presence of circulating tumor cells.
“These results suggest an assessment of circulating tumor cells might provide important prognostic information in these patients,” they wrote.
Additional studies are needed to determine how well circulating tumor cells predict recurrence and death in patients who already have had chemotherapy, the researchers said.
Disclosure: The researchers report no relevant financial disclosures.
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