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

Abstract 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) i...

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Autores principales:	Costanza Paoletti, Meredith M. Regan, Samuel M. Niman, Emily M. Dolce, Elizabeth P. Darga, Minetta C. Liu, P. Kelly Marcom, Lowell L. Hart, John W. Smith, Karen L. Tedesco, Eitan Amir, Ian E. Krop, Angela M. DeMichele, Pamela J. Goodwin, Margaret Block, Kimberly Aung, Martha E. Brown, Robert T. McCormack, Daniel F. Hayes
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/a4591a6d3a9d4069a97a9133183bb04c
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spelling	oai:doaj.org-article:a4591a6d3a9d4069a97a9133183bb04c2021-12-02T17:34:46ZCirculating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients10.1038/s41523-021-00281-12374-4677https://doaj.org/article/a4591a6d3a9d4069a97a9133183bb04c2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41523-021-00281-1https://doaj.org/toc/2374-4677Abstract 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.Costanza PaolettiMeredith M. ReganSamuel M. NimanEmily M. DolceElizabeth P. DargaMinetta C. LiuP. Kelly MarcomLowell L. HartJohn W. SmithKaren L. TedescoEitan AmirIan E. KropAngela M. DeMichelePamela J. GoodwinMargaret BlockKimberly AungMartha E. BrownRobert T. McCormackDaniel F. HayesNature PortfolioarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENnpj Breast Cancer, Vol 7, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Costanza Paoletti Meredith M. Regan Samuel M. Niman Emily M. Dolce Elizabeth P. Darga Minetta C. Liu P. Kelly Marcom Lowell L. Hart John W. Smith Karen L. Tedesco Eitan Amir Ian E. Krop Angela M. DeMichele Pamela J. Goodwin Margaret Block Kimberly Aung Martha E. Brown Robert T. McCormack Daniel F. Hayes Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients
description	Abstract 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.
format	article
author	Costanza Paoletti Meredith M. Regan Samuel M. Niman Emily M. Dolce Elizabeth P. Darga Minetta C. Liu P. Kelly Marcom Lowell L. Hart John W. Smith Karen L. Tedesco Eitan Amir Ian E. Krop Angela M. DeMichele Pamela J. Goodwin Margaret Block Kimberly Aung Martha E. Brown Robert T. McCormack Daniel F. Hayes
author_facet	Costanza Paoletti Meredith M. Regan Samuel M. Niman Emily M. Dolce Elizabeth P. Darga Minetta C. Liu P. Kelly Marcom Lowell L. Hart John W. Smith Karen L. Tedesco Eitan Amir Ian E. Krop Angela M. DeMichele Pamela J. Goodwin Margaret Block Kimberly Aung Martha E. Brown Robert T. McCormack Daniel F. Hayes
author_sort	Costanza Paoletti
title	Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients
title_short	Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients
title_full	Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients
title_fullStr	Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients
title_full_unstemmed	Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients
title_sort	circulating tumor cell number and endocrine therapy index in er positive metastatic breast cancer patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/a4591a6d3a9d4069a97a9133183bb04c
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Circulating tumor cell number and endocrine therapy index in ER positive metastatic breast cancer patients

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