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Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients.

Publication ,  Journal Article
Paoletti, C; Regan, MM; Niman, SM; Dolce, EM; Darga, EP; Liu, MC; Marcom, PK; Hart, LL; Smith, JW; Tedesco, KL; Amir, E; Krop, IE; Block, M ...
Published in: NPJ Breast Cancer
June 11, 2021

Circulating tumor cells (CTC) are prognostic in metastatic breast cancer (MBC). The CTC-endocrine therapy index (CTC-ETI), consisting of CTC-ER (estrogen receptor), BCL2, human epidermal growth factor receptor (HER2), and Ki67 expression, might predict resistance to endocrine therapy (ET) in patients with ER-positive MBC. One hundred twenty-one patients with ER-positive/HER2-negative MBC initiating a new ET after ≥1 lines of ET were enrolled in a prospective, multi-institutional clinical trial. CTC-ETI and clinical/imaging follow-up were performed at baseline and serial time points. Progression-free survival (PFS) and rapid progression (RP; determined at the 3-month time point) were primary endpoints. Associations with clinical outcomes used logrank and Fisher's exact tests. At baseline, 36% (38/107) of patients had ≥5 CTC/7.5 ml whole blood (WB). Patients with ≥5 vs. <5 CTC/7.5 ml WB had significantly worse PFS (median 3.3 vs. 5.9 months, P = 0.03). Elevated CTC at 1 month was associated with even worse PFS (1.9 vs. 5.0 months from the 1-month sample, P < 0.001). Low, intermediate, and high CTC-ETI were observed in 71 (66%), 8 (8%), and 28 (26%) patients, with median PFS of 6.9, 8.5, and 2.8 months, respectively (P = 0.008). Patients with high vs. low CTC and CTC-ETI more frequently experienced RP (CTC: 66% vs. 41%; P = 0.03; CTC-ETI: 79% vs. 40%; P = 0.002). In conclusion, CTC enumeration and the CTC-ETI assay are prognostic at baseline and follow-up in patients with ER-positive/HER2-negative MBC starting new ET. CTC at first follow-up might identify a group of patients with ER-positive MBC that could forego ET, but CTC-ETI did not contribute further.

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Published In

NPJ Breast Cancer

DOI

ISSN

2374-4677

Publication Date

June 11, 2021

Volume

7

Issue

1

Start / End Page

77

Location

United States

Related Subject Headings

  • 4202 Epidemiology
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Paoletti, C., Regan, M. M., Niman, S. M., Dolce, E. M., Darga, E. P., Liu, M. C., … Hayes, D. F. (2021). Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients. NPJ Breast Cancer, 7(1), 77. https://doi.org/10.1038/s41523-021-00281-1
Paoletti, Costanza, Meredith M. Regan, Samuel M. Niman, Emily M. Dolce, Elizabeth P. Darga, Minetta C. Liu, P Kelly Marcom, et al. “Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients.NPJ Breast Cancer 7, no. 1 (June 11, 2021): 77. https://doi.org/10.1038/s41523-021-00281-1.
Paoletti C, Regan MM, Niman SM, Dolce EM, Darga EP, Liu MC, et al. Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients. NPJ Breast Cancer. 2021 Jun 11;7(1):77.
Paoletti, Costanza, et al. “Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients.NPJ Breast Cancer, vol. 7, no. 1, June 2021, p. 77. Pubmed, doi:10.1038/s41523-021-00281-1.
Paoletti C, Regan MM, Niman SM, Dolce EM, Darga EP, Liu MC, Marcom PK, Hart LL, Smith JW, Tedesco KL, Amir E, Krop IE, DeMichele AM, Goodwin PJ, Block M, Aung K, Brown ME, McCormack RT, Hayes DF. Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients. NPJ Breast Cancer. 2021 Jun 11;7(1):77.

Published In

NPJ Breast Cancer

DOI

ISSN

2374-4677

Publication Date

June 11, 2021

Volume

7

Issue

1

Start / End Page

77

Location

United States

Related Subject Headings

  • 4202 Epidemiology
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences