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Circulating tumor cells in newly diagnosed inflammatory breast cancer.

Mego M, Giordano A, De Giorgi U, Masuda H, Hsu L, Giuliano M, Fouad TM, Dawood S, Ueno NT, Valero V, Andreopoulou E, Alvarez RH, Woodward WA, Hortobagyi GN, Cristofanilli M, Reuben JM - Breast Cancer Res. (2015)

Bottom Line: Patients with fewer than five CTCs had significantly better progression-free survival (PFS) (hazard ratio (HR)=0.60; P=0.02) and overall survival (HR=0.59; P=0.03) than patients with five or more CTCs.Among patients with stage III IBC, there was a nonsignificant difference in PFS (HR=0.66; 95% confidence interval (CI), 0.31 to 1.39; P=0.29) and OS (HR=0.54; 95% CI, 0.24 to 1.26; P=0.48) in patients with no CTCs compared with patients with one or more CTCs.CTCs can be detected in a large proportion of patients with newly diagnosed IBC and are a strong predictor of worse prognosis in patients with newly diagnosed IBC.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. misomego@gmail.com.

ABSTRACT

Introduction: Circulating tumor cells (CTCs) are an independent prognostic factor for progression-free survival (PFS) and overall survival (OS) in patients with metastatic breast cancer. Inflammatory breast cancer (IBC) is one of the most aggressive forms of breast cancer. The prognostic value of a CTC count in newly diagnosed IBC has not been established. The aim of this study was to assess the prognostic value of a baseline CTC count in patients with newly diagnosed IBC.

Methods: This retrospective study included 147 patients with newly diagnosed IBC (77 with locally advanced and 70 with metastatic IBC) treated with neoadjuvant therapy or first-line chemotherapy during the period from January 2004 through December 2012 at The University of Texas MD Anderson Cancer Center. CTCs were detected and enumerated by using the CellSearch system before patients were started with chemotherapy.

Results: The proportion of patients with ≥1 CTC was lower among patients with stage III than among patients with metastatic IBC (54.5% versus 84.3%; P=0.0002); the proportion of patients with ≥5 CTCs was also lower for stage III than for metastatic IBC (19.5% versus 47.1%; P=0.0004). Patients with fewer than five CTCs had significantly better progression-free survival (PFS) (hazard ratio (HR)=0.60; P=0.02) and overall survival (HR=0.59; P=0.03) than patients with five or more CTCs. Among patients with stage III IBC, there was a nonsignificant difference in PFS (HR=0.66; 95% confidence interval (CI), 0.31 to 1.39; P=0.29) and OS (HR=0.54; 95% CI, 0.24 to 1.26; P=0.48) in patients with no CTCs compared with patients with one or more CTCs. In multivariate analysis, CTC was prognostic for PFS and OS independent of clinical stage.

Conclusions: CTCs can be detected in a large proportion of patients with newly diagnosed IBC and are a strong predictor of worse prognosis in patients with newly diagnosed IBC.

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Kaplan-Meier estimates of probabilities of progression-free survival, according to baseline circulating tumor cell count in patients with newly diagnosed inflammatory breast cancer.
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Fig2: Kaplan-Meier estimates of probabilities of progression-free survival, according to baseline circulating tumor cell count in patients with newly diagnosed inflammatory breast cancer.

Mentions: At a median follow-up time of 26.3 months (range, 1.0 to 92.4 months), 81 patients (55.1%) had experienced disease progression, and 66 patients (44.9%) had died. Median follow-up of patients still alive was 35.6 (range, 8.2 to 92.4 months). Patients with fewer than five CTCs had a significantly better PFS than patients with five or more CTCs (median PFS, 26.4 versus 10.5 months; hazard ratio [HR] = 0.60; 95% CI, 0.37 to 0.98; P = 0.02) (Figure 2). Furthermore, patients with fewer than five CTCs had a significantly better OS than patients with five or more CTCs (median OS, 56.9 versus 32.7 months; HR = 0.59; 95% CI, 0.35 to 1.00; P = 0.03) (Figure 3). Similarly, with a cut-off of one CTC, patients with fewer than one CTCs had a significantly better PFS (HR = 0.42; 95% CI, 0.27 to0.66; P = 0.001) and OS (HR = 0.35; 95% CI, 0.21 to 0.58; P = 0.001) compared with patients with one or more 1CTCs.Figure 2


Circulating tumor cells in newly diagnosed inflammatory breast cancer.

Mego M, Giordano A, De Giorgi U, Masuda H, Hsu L, Giuliano M, Fouad TM, Dawood S, Ueno NT, Valero V, Andreopoulou E, Alvarez RH, Woodward WA, Hortobagyi GN, Cristofanilli M, Reuben JM - Breast Cancer Res. (2015)

Kaplan-Meier estimates of probabilities of progression-free survival, according to baseline circulating tumor cell count in patients with newly diagnosed inflammatory breast cancer.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4318180&req=5

Fig2: Kaplan-Meier estimates of probabilities of progression-free survival, according to baseline circulating tumor cell count in patients with newly diagnosed inflammatory breast cancer.
Mentions: At a median follow-up time of 26.3 months (range, 1.0 to 92.4 months), 81 patients (55.1%) had experienced disease progression, and 66 patients (44.9%) had died. Median follow-up of patients still alive was 35.6 (range, 8.2 to 92.4 months). Patients with fewer than five CTCs had a significantly better PFS than patients with five or more CTCs (median PFS, 26.4 versus 10.5 months; hazard ratio [HR] = 0.60; 95% CI, 0.37 to 0.98; P = 0.02) (Figure 2). Furthermore, patients with fewer than five CTCs had a significantly better OS than patients with five or more CTCs (median OS, 56.9 versus 32.7 months; HR = 0.59; 95% CI, 0.35 to 1.00; P = 0.03) (Figure 3). Similarly, with a cut-off of one CTC, patients with fewer than one CTCs had a significantly better PFS (HR = 0.42; 95% CI, 0.27 to0.66; P = 0.001) and OS (HR = 0.35; 95% CI, 0.21 to 0.58; P = 0.001) compared with patients with one or more 1CTCs.Figure 2

Bottom Line: Patients with fewer than five CTCs had significantly better progression-free survival (PFS) (hazard ratio (HR)=0.60; P=0.02) and overall survival (HR=0.59; P=0.03) than patients with five or more CTCs.Among patients with stage III IBC, there was a nonsignificant difference in PFS (HR=0.66; 95% confidence interval (CI), 0.31 to 1.39; P=0.29) and OS (HR=0.54; 95% CI, 0.24 to 1.26; P=0.48) in patients with no CTCs compared with patients with one or more CTCs.CTCs can be detected in a large proportion of patients with newly diagnosed IBC and are a strong predictor of worse prognosis in patients with newly diagnosed IBC.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. misomego@gmail.com.

ABSTRACT

Introduction: Circulating tumor cells (CTCs) are an independent prognostic factor for progression-free survival (PFS) and overall survival (OS) in patients with metastatic breast cancer. Inflammatory breast cancer (IBC) is one of the most aggressive forms of breast cancer. The prognostic value of a CTC count in newly diagnosed IBC has not been established. The aim of this study was to assess the prognostic value of a baseline CTC count in patients with newly diagnosed IBC.

Methods: This retrospective study included 147 patients with newly diagnosed IBC (77 with locally advanced and 70 with metastatic IBC) treated with neoadjuvant therapy or first-line chemotherapy during the period from January 2004 through December 2012 at The University of Texas MD Anderson Cancer Center. CTCs were detected and enumerated by using the CellSearch system before patients were started with chemotherapy.

Results: The proportion of patients with ≥1 CTC was lower among patients with stage III than among patients with metastatic IBC (54.5% versus 84.3%; P=0.0002); the proportion of patients with ≥5 CTCs was also lower for stage III than for metastatic IBC (19.5% versus 47.1%; P=0.0004). Patients with fewer than five CTCs had significantly better progression-free survival (PFS) (hazard ratio (HR)=0.60; P=0.02) and overall survival (HR=0.59; P=0.03) than patients with five or more CTCs. Among patients with stage III IBC, there was a nonsignificant difference in PFS (HR=0.66; 95% confidence interval (CI), 0.31 to 1.39; P=0.29) and OS (HR=0.54; 95% CI, 0.24 to 1.26; P=0.48) in patients with no CTCs compared with patients with one or more CTCs. In multivariate analysis, CTC was prognostic for PFS and OS independent of clinical stage.

Conclusions: CTCs can be detected in a large proportion of patients with newly diagnosed IBC and are a strong predictor of worse prognosis in patients with newly diagnosed IBC.

Show MeSH
Related in: MedlinePlus