BACKGROUND: Triple-negative breast cancer (TNBC) is characterized by a lack of estrogen and progesterone receptor expression and HER-2 gene amplification. Circulating tumor cells (CTCs) can be identified in 25 % of nonmetastatic breast cancer patients, and the identification of ≥1 CTC predicts outcome. This study was designed to determine whether CTCs present after neoadjuvant chemotherapy (NACT) predicted worse outcome in nonmetastatic TNBC patients. METHODS: CTCs were assessed in 57 TNBC patients with nonmetastatic TNBC after the completion of NACT. CTCs (per 7.5 ml blood) were identified using the Cell Search(®) System (Janssen). Log-rank test and Cox regression analysis were applied to establish the association of CTCs with relapse-free (RFS) and overall survival (OS). RESULTS: Median follow-up was 30 months, and mean age was 53 years. Fifty-four patients (95 %) had >2-cm tumors, 42 (84 %) were nuclear grade 3, and 42 (74 %) had positive axillary lymph nodes. One or more CTC was identified in 30 % of patients. CTC presence was not associated with primary tumor size, high grade, or lymph node positivity. Multivariate analysis demonstrated that detection of ≥1 CTC predicted decreased RFS (log-rank P = 0.03, HR 5.25, 95 % CI 1.34-20.56) and OS (log-rank P = 0.03, HR 7.04, 95 % CI 1.26-39.35). CONCLUSIONS: One or more CTCs present after NACT predicted relapse and survival in nonmetastatic TNBC patients. This information would be helpful in future clinical trial design of adjuvant treatments for TNBC patients who are at risk for relapse after completing NACT.
BACKGROUND: Triple-negative breast cancer (TNBC) is characterized by a lack of estrogen and progesterone receptor expression and HER-2 gene amplification. Circulating tumor cells (CTCs) can be identified in 25 % of nonmetastatic breast cancerpatients, and the identification of ≥1 CTC predicts outcome. This study was designed to determine whether CTCs present after neoadjuvant chemotherapy (NACT) predicted worse outcome in nonmetastatic TNBC patients. METHODS: CTCs were assessed in 57 TNBC patients with nonmetastatic TNBC after the completion of NACT. CTCs (per 7.5 ml blood) were identified using the Cell Search(®) System (Janssen). Log-rank test and Cox regression analysis were applied to establish the association of CTCs with relapse-free (RFS) and overall survival (OS). RESULTS: Median follow-up was 30 months, and mean age was 53 years. Fifty-four patients (95 %) had >2-cm tumors, 42 (84 %) were nuclear grade 3, and 42 (74 %) had positive axillary lymph nodes. One or more CTC was identified in 30 % of patients. CTC presence was not associated with primary tumor size, high grade, or lymph node positivity. Multivariate analysis demonstrated that detection of ≥1 CTC predicted decreased RFS (log-rank P = 0.03, HR 5.25, 95 % CI 1.34-20.56) and OS (log-rank P = 0.03, HR 7.04, 95 % CI 1.26-39.35). CONCLUSIONS: One or more CTCs present after NACT predicted relapse and survival in nonmetastatic TNBC patients. This information would be helpful in future clinical trial design of adjuvant treatments for TNBC patients who are at risk for relapse after completing NACT.
Authors: Chelain R Goodman; Brandon-Luke L Seagle; Thomas W P Friedl; Brigitte Rack; Krisztian Lato; Visnja Fink; Massimo Cristofanilli; Eric D Donnelly; Wolfgang Janni; Shohreh Shahabi; Jonathan B Strauss Journal: JAMA Oncol Date: 2018-08-09 Impact factor: 31.777
Authors: Oluwadamilola M Fayanju; Carolyn S Hall; Jessica Bowman Bauldry; Mandar Karhade; Lily M Valad; Henry M Kuerer; Sarah M DeSnyder; Carlos H Barcenas; Anthony Lucci Journal: Am J Surg Date: 2017-06-23 Impact factor: 2.565
Authors: Haeyoung Kim; Yeon Jeong Kim; Donghyun Park; Woong-Yang Park; Doo Ho Choi; Won Park; Won Kyung Cho; Nalee Kim Journal: Breast Cancer Res Treat Date: 2021-06-21 Impact factor: 4.872
Authors: Ryan J O Dowling; Joseph A Sparano; Pamela J Goodwin; Francois-Clement Bidard; David W Cescon; Sarat Chandarlapaty; Joseph O Deasy; Mitch Dowsett; Robert J Gray; N Lynn Henry; Funda Meric-Bernstam; Jane Perlmutter; George W Sledge; Mangesh A Thorat; Scott V Bratman; Lisa A Carey; Martin C Chang; Angela DeMichele; Marguerite Ennis; Katarzyna J Jerzak; Larissa A Korde; Ana Elisa Lohmann; Eleftherios P Mamounas; Wendy R Parulekar; Meredith M Regan; Daniel Schramek; Vuk Stambolic; Timothy J Whelan; Antonio C Wolff; Jim R Woodgett; Kevin Kalinsky; Daniel F Hayes Journal: JNCI Cancer Spectr Date: 2019-08-10