Original Paper

Journal of Cancer Research and Clinical Oncology

, Volume 134, Issue 1, pp 59-65

First online:

An increase in cell number at completion of therapy may develop as an indicator of early relapse

Quantification of circulating epithelial tumor cells (CETC) for monitoring of adjuvant therapy in breast cancer
  • Katharina PachmannAffiliated withClinic for Internal Medicine II, Friedrich Schiller University JenaLabor für spezielle Immunhämatologie und GendiagnostikDepartment of Experimental Hematology and Oncology, Clinic for Internal Medicine II, Friedrich Schiller Universität Jena Email author 
  • , Robert DenglerAffiliated withPractice for Internal Medicine, Hematology and Oncology
  • , Kurt LobodaschAffiliated withWomens Hospital Deutsches Rot-Kreuz Krankenhaus
  • , Frank FröhlichAffiliated withWomens Hospital Deutsches Rot-Kreuz Krankenhaus
  • , Torsten KrollAffiliated withClinic for Internal Medicine II, Friedrich Schiller University Jena
  • , Matthias RengsbergerAffiliated withClinic for Internal Medicine II, Friedrich Schiller University Jena
  • , Rene SchubertAffiliated withClinic for Internal Medicine II, Friedrich Schiller University Jena
  • , Ulrich PachmannAffiliated withLabor für spezielle Immunhämatologie und Gendiagnostik

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Purpose

Treatment efficiency of adjuvant therapy in breast cancer is only revealed after several years by statistical evaluation and gives no answer for the individual patient. We here present a method to analyze the response to adjuvant chemotherapy online in individual patients.

Methods/results

In 25 consecutive non-metastatic primary breast cancer patients adjuvant fluorouracil/epirubicin/cyclophosphamid (FEC) or EC followed by taxane (EC-T) or cyclophosphamid/methotrexate/fluorouracil (CMF) therapy were given. Circulating epithelial tumor cells (CETC) were quantified before and after each second cycle of the therapy regimen, between the anthracycline and the taxane block of the regimen and in some cases repeatedly during CMF treatment. Independent of the initial cell number CETC numbers showed a decline, no change or a minor increase in 15 patients of which 14 remained in complete remission and 1 suffered local relapse. Ten patients showed an increase at the end of therapy of which 4 have relapsed during the observation time of between 2 months and up to 54 months. This patient group was compared to a previously published group of 25 patients who have all reached a follow-up of 4.5 years or until relapse.

Conclusion

As in the previous report, Kaplan–Meier analysis revealed a high correlation between the response of CETC to therapy and relapse (p < 0.0001) and curves of both patient groups were super imposable. Multivariate analysis revealed the response of CETC to therapy to be an independent predictive marker for relapse.

Keywords

Increase in number of circulating tumor cells Relapse