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Simultaneous detection of circulating and disseminated tumor cells in primary breast cancer patients following neoadjuvant chemotherapy

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Pathological complete response (pCR) is a common endpoint in neoadjuvant chemotherapy (NACT) of primary breast cancer patients (PBC), but does not address the systemic prevalence of minimal residual disease. In this study, we compared pCR with the detection of circulating (CTC) and disseminated tumor cells (DTC) following NACT, as well as their impact on survival.

Methods

Patients with PBC receiving NACT and consecutive surgery were eligible for this study. CTCs were detected using the CellSearch® system and DTCs were determined using immunocytochemistry (cytokeratin staining with the A45-B/B3 antibody). pCR was defined as ypT0/ypTis and ypN0.

Results

58 patients were included in the analysis with a median follow-up of 30 months. Of these, 5 (9%) presented with CTCs and 36 (62%) with DTCs. 16 patients (28%) achieved a pCR. No significant correlation between CTCs, DTCs and pCR and no statistically significant impact on disease free (DFS) or overall survival (OS) was apparent.

Conclusions

Both CTCs and DTCs are detectable after NACT. As we could not show a significant relationship between CTC detection, DTC detection and pCR, all three methods may provide independent information regarding treatment response. Since we were unable to show a significant impact on survival, larger prospective studies that include CTCs and DTCs are needed. These trials should include the molecular characterization of primary tumor tissue, CTCs and DTCs to determine whether these cells are independent subpopulations of malignant cell clones.

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Abbreviations

NACT:

Neoadjuvant chemotherapy

PBC:

Primary breast cancer

DFS:

Disease free survival

OS:

Overall survival

pCR:

Pathological complete response

MRD:

Minimal residual disease

DTC:

Disseminated tumor cell

BM:

Bone marrow

CTC:

Circulating tumor cell

HR:

Hormone receptor

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Tuebingen, Tuebingen, Germany

    Vincent P. Walter, Florin-Andrei Taran, Markus Hahn, Sara Y. Brucker & Andreas D. Hartkopf

  2. Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany

    Markus Wallwiener

Authors
  1. Vincent P. Walter
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  2. Florin-Andrei Taran
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  3. Markus Wallwiener
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  4. Markus Hahn
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  5. Sara Y. Brucker
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  6. Andreas D. Hartkopf
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Contributions

VPW: data collection, data analysis, manuscript writing. FAT: project development. MW: data collection. MH: data collection. SYB: Project development. ADH: data collection, data analysis, manuscript editing.

Corresponding author

Correspondence to Vincent P. Walter.

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The experiments conducted comply with current German laws.

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The authors declare that they have no conflict of interest.

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Walter, V.P., Taran, FA., Wallwiener, M. et al. Simultaneous detection of circulating and disseminated tumor cells in primary breast cancer patients following neoadjuvant chemotherapy. Arch Gynecol Obstet 297, 785–790 (2018). https://doi.org/10.1007/s00404-018-4669-9

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  • DOI: https://doi.org/10.1007/s00404-018-4669-9

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