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Prospective assessment of the prognostic value of circulating tumor cells and their clusters in patients with advanced-stage breast cancer.

Publication ,  Journal Article
Mu, Z; Wang, C; Ye, Z; Austin, L; Civan, J; Hyslop, T; Palazzo, JP; Jaslow, R; Li, B; Myers, RE; Jiang, J; Xing, J; Yang, H; Cristofanilli, M
Published in: Breast Cancer Res Treat
December 2015

The enumeration of circulating tumor cells (CTCs) provides important prognostic values in patients with metastatic breast cancer. Recent studies indicate that individual CTCs form clusters and these CTC-clusters play an important role in tumor metastasis. We aimed to assess whether quantification of CTC-clusters provides additional prognostic value over quantification of individual CTCs alone. In 115 prospectively enrolled advanced-stage (III and IV) breast cancer patients, CTCs and CTC-clusters were counted in 7.5 ml whole blood using the CellSearch system at baseline before first-line therapy. The individual and joint effects of CTC and CTC cluster counts on patients' progression-free survival (PFS) were analyzed using Cox proportional hazards modeling. Of the 115 patients, 36 (31.3 %) had elevated baseline CTCs (≥5 CTCs/7.5 ml) and 20 (17.4 %) had CTC-clusters (≥2 CTCs/7.5 ml). Patients with elevated CTCs and CTC-clusters both had worse PFS with a hazard ratio (HR) of 2.76 [95 % confidence interval (CI) 1.57-4.86, P log-rank = 0.0005] and 2.83 (1.48-5.39, P log-rank = 0.001), respectively. In joint analysis, compared with patients with <5 CTCs and without CTC-clusters, patients with elevated CTCs but without clusters, and patients with elevated CTCs and with clusters, had an increasing trend of progression risk, with an HR of 2.21 (1.02-4.78) and 3.32 (1.68-6.55), respectively (P log-rank = 0.0006, P trend = 0.0002). The additional prognostic value of CTC-clusters appeared to be more pronounced in patients with inflammatory breast cancer (IBC), the most aggressive form of breast cancer with the poorest survival. Baseline counts of both individual CTCs and CTC-clusters were associated with PFS in advanced-stage breast cancer patients. CTC-clusters might provide additional prognostic value compared with CTC enumeration alone, in patients with elevated CTCs.

Duke Scholars

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Published In

Breast Cancer Res Treat

DOI

EISSN

1573-7217

Publication Date

December 2015

Volume

154

Issue

3

Start / End Page

563 / 571

Location

Netherlands

Related Subject Headings

  • Prospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplastic Cells, Circulating
  • Middle Aged
  • Kaplan-Meier Estimate
  • Inflammatory Breast Neoplasms
  • Humans
  • Female
  • Disease-Free Survival
 

Citation

APA
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Mu, Z., Wang, C., Ye, Z., Austin, L., Civan, J., Hyslop, T., … Cristofanilli, M. (2015). Prospective assessment of the prognostic value of circulating tumor cells and their clusters in patients with advanced-stage breast cancer. Breast Cancer Res Treat, 154(3), 563–571. https://doi.org/10.1007/s10549-015-3636-4
Mu, Zhaomei, Chun Wang, Zhong Ye, Laura Austin, Jesse Civan, Terry Hyslop, Juan P. Palazzo, et al. “Prospective assessment of the prognostic value of circulating tumor cells and their clusters in patients with advanced-stage breast cancer.Breast Cancer Res Treat 154, no. 3 (December 2015): 563–71. https://doi.org/10.1007/s10549-015-3636-4.
Mu Z, Wang C, Ye Z, Austin L, Civan J, Hyslop T, et al. Prospective assessment of the prognostic value of circulating tumor cells and their clusters in patients with advanced-stage breast cancer. Breast Cancer Res Treat. 2015 Dec;154(3):563–71.
Mu, Zhaomei, et al. “Prospective assessment of the prognostic value of circulating tumor cells and their clusters in patients with advanced-stage breast cancer.Breast Cancer Res Treat, vol. 154, no. 3, Dec. 2015, pp. 563–71. Pubmed, doi:10.1007/s10549-015-3636-4.
Mu Z, Wang C, Ye Z, Austin L, Civan J, Hyslop T, Palazzo JP, Jaslow R, Li B, Myers RE, Jiang J, Xing J, Yang H, Cristofanilli M. Prospective assessment of the prognostic value of circulating tumor cells and their clusters in patients with advanced-stage breast cancer. Breast Cancer Res Treat. 2015 Dec;154(3):563–571.
Journal cover image

Published In

Breast Cancer Res Treat

DOI

EISSN

1573-7217

Publication Date

December 2015

Volume

154

Issue

3

Start / End Page

563 / 571

Location

Netherlands

Related Subject Headings

  • Prospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplastic Cells, Circulating
  • Middle Aged
  • Kaplan-Meier Estimate
  • Inflammatory Breast Neoplasms
  • Humans
  • Female
  • Disease-Free Survival