, Volume 122, Issue 1, pp 219-220
Date: 04 Feb 2010

Information from CTC measurements for metastatic breast cancer prognosis—we should do more than selecting an “optimal cut point”

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Circulating tumor cells (CTCs) are discussed as a new prognostic marker in metastatic breast cancer. Fifty to 80% of metastatic patients have circulating tumor cells in the blood circulation [13]. The most currently used approach for CTC detection is the CellSearch™ system which is an semiautomated device based on immunofluorescence and flow cytometry. CTCs are isolated by immunomagnetic beads coated with antibodies against the epithelial cell adhesion molecule (EpCAM) and identified by cytokeratin-positivity, positive nuclear staining and CD 45 negativity. In contrast to the RT–PCR based approaches (e.g. AdnaTest), CTCs can be quantified.

Cristofanilli et al. [1] used the first 102 patients (training set) from a prospective multi-center trial to select a cutoff point for CTC count to stratify patients into two groups with good or poor clinical outcome and used the 75 subsequently enrolled patients as a validation set. Aiming for the clearest separation, thresholds of 1–10,000 CTCs wer

This is an invited commentary to article doi: 10.1007/s10549-009-0668-7