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Circulating Tumor Cells After Neoadjuvant Chemotherapy in Stage I–III Triple-Negative Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

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.

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Acknowledgment

This work was supported by The Society of Surgical Oncology Clinical Investigator Award (A Lucci), The Morgan Welch Inflammatory Breast Cancer Program, and The Institute for Personalized Therapy at U.T. M.D. Anderson Cancer Center, the State of Texas Rare and Aggressive Breast Cancer Research Program, and philanthropic funds for which we thank our many generous donors.

Disclosures

Dr. Lucci served as a consultant at Janssen Diagnostics in December, 2014.

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Authors and Affiliations

  1. Department of Surgical Oncology, Unit 444, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Carolyn Hall PhD, Mandar Karhade MBBS, MPH, Barbara Laubacher BSN, Amber Anderson BS, Henry Kuerer MD, PhD, Sarah DeSynder MD & Anthony Lucci MD

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  1. Carolyn Hall PhD
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  2. Mandar Karhade MBBS, MPH
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  7. Anthony Lucci MD
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Correspondence to Anthony Lucci MD.

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Hall, C., Karhade, M., Laubacher, B. et al. Circulating Tumor Cells After Neoadjuvant Chemotherapy in Stage I–III Triple-Negative Breast Cancer. Ann Surg Oncol 22 (Suppl 3), 552–558 (2015). https://doi.org/10.1245/s10434-015-4600-6

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  • DOI: https://doi.org/10.1245/s10434-015-4600-6

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