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Circulating tumour cells in peripheral blood: potential impact on breast cancer outcome

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Abstract

Introduction

In breast cancer, the metastatic process may involve the dissemination of circulating tumour cells (CTCs) through the blood and lymphatic system prior to the colonisation of distant organs. Here we demonstrate the predictive capacity of CTCs for detecting risk of death in breast cancer patients during established time intervals.

Methods

CTCs were identified by immunocytochemical methods following isolation by selective immunomagnetic cell separation of cytokeratin-positive cells. Serial blood samples from 65 patients were collected at roughly monthly intervals for up to 50 months. Follow-up was conducted at different intervals: 1–5, >5–12, >12–24 and >24–50 months.

Results

Both presence and number of CTCs were correlated to risk of death: patients with CTCs at any time during follow-up had a higher risk of death (p=0.035) than patients without CTCs. Furthermore, during the first 5 months of therapy, patients with >5 CTCs had a higher risk of death than patients with <5 CTCs (p=0.002).

Conclusions

Our results show that the persistence of CTCs after chemotherapy, particularly during the first 5 months, could define a group of patients with a high risk of relapse.

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References

  1. Braun S, Vogl F, Naume B et al (2005) A pooled analysis of bone marrow micrometastasis in breast cancer. N Engl J Med 353:793–802

    Article  PubMed  CAS  Google Scholar 

  2. Nakagawa T, Martinez S, Goto Y et al (2007) Detection of circulating tumor cells in early-stage breast cancer metastasis to axillary lymph nodes. Clin Cancer Res 13:4105–4110

    Article  PubMed  CAS  Google Scholar 

  3. Ignatiadis M, Kallergi G, Ntoulia M et al (2008) Prognostic value of the molecular detection of circulating tumor cells using a multimarker reverse transcription-PCR assay for cytokeratin 19, mammaglobin A, and HER2 in early breast cancer. Clin Cancer Res 14:2593–2600

    Article  PubMed  CAS  Google Scholar 

  4. Serrano M, Sanchez-Rovira P, Delgado-Rodriguez M, Gaforio JJ (2009) Detection of circulating tumor cells in the context of treatment: prognostic value in breast cancer patients. Cancer Biol Therapy 8:671–675

    Article  Google Scholar 

  5. Pierga J, Bonnetón C, Vincent Salomón A et al (2004) Clinical significance of immunocytochemical detection of tumor cells using digital microscopy in peripheral blood and bone marrow of breast cancer patients. Clin Cancer Res 10:1392–1400

    Article  PubMed  CAS  Google Scholar 

  6. Tewes M, Aktas B, Welt A et al (2009) Molecular profiling and predictive value of circulating tumor cells in patients with metastatic breast cancer: an option for monitoring response to breast cancer related therapies. Breast Cancer Res 115:181–190

    Article  Google Scholar 

  7. Konecny G, Pauletti G, Pegram M et al (2003) Quantitative association between HER-2/neu and steroid hormone receptors in hormone receptorpositive primary breast cancer. J Natl Cancer Inst 95:142–153

    Article  PubMed  CAS  Google Scholar 

  8. Wülfing P, Borchard J, Buerger H et al (2006) Her2-positive circulating tumor cells indicate poor clinical outcome in stage I to III breast cancer patients. Clin Cancer Res 12:1715–1720

    Article  PubMed  Google Scholar 

  9. Gaforio J, Serrano M, Sanchez-Rovira P et al (2003) Detection of breast cancer cells in the peripheral blood is positively correlated with estrogen- receptor status and predicts for poor prognosis. Int J Cancer 107:984–990

    Article  PubMed  CAS  Google Scholar 

  10. Xenidis N, Vlachonikolis I, Mavroudis D et al (2003) Peripheral blood circulating cytokeratin-19 mRNA-positive cells after the completion of adjuvant chemotherapy in patients with operable breast cancer. Ann Oncol 14:849–855

    Article  PubMed  CAS  Google Scholar 

  11. Pantel K, Muller V, Auer M et al (2003) Detection and clinical implications of early systemic tumor cell dissemination in breast cancer. Clin Cancer Res 9:6326–6334

    PubMed  CAS  Google Scholar 

  12. Riethdorf S, Wikman H, Pantel K (2008) Biological relevance of disseminated tumor cells in cancer patients. Int J Cancer 123:1991–2003

    Article  PubMed  CAS  Google Scholar 

  13. Schindlbeck C, Kampik T, Janni W et al (2005) Prognostic relevance of disseminated tumor cells in the bone marrow and biological factors of 265 primary breast carcinomas. Breast Cancer Res 7:R1174–R1185

    Article  PubMed  Google Scholar 

  14. Woelfle U, Breit E, Zafrakas K (2005) Bi-specific immunomagnetic enrichment of micrometastatic tumour cell clusters from bone marrow of cancer patients. J Immunol Methods 300:136–145

    Article  PubMed  CAS  Google Scholar 

  15. Rudolph P, MacGrogan G, Bonichon F et al (1999) Prognostic significance of Ki-67 and topoisomerase IIalpha expression in infiltrating ductal carcinoma of the breast. A multivariate analysis of 863 cases. Breast Cancer Res Treat 55:61–71

    Article  PubMed  CAS  Google Scholar 

  16. Nagrath S, Sequist LV, Maheswaran S et al (2007) Isolation of rare circulating tumour cells in cancer patients by microchip technology. Nature 450:1235–1239

    Article  PubMed  CAS  Google Scholar 

  17. Hayes D, Cristofanilli M, Budd G et al (2006) Circulating tumor cells at each follow-up time point during therapy of metastatic breast cancer patients predict progression-free and overall survival. Clin Cancer Res 12:4218–4224

    Article  PubMed  CAS  Google Scholar 

  18. Ashworth T (1869) A case of cancer in which cells similar to those in the tumours were seen in the blood after death. Aust Med J 14:146–149

    Google Scholar 

  19. Riethdorf S, Pantel K (2008) Disseminated tumor cells in bone marrow and circulating tumor cells in blood of breast cancer patients: current state of detection and characterization. Pathobiology 75:140–148

    Article  PubMed  Google Scholar 

  20. Xenidis N, Perraki M, Kafousi M et al (2006) Predictive and prognostic value of peripheral blood cytokeratin-19 mRNA-positive cells detected by real-time polymerase chain reaction in node-negative breast cancer patients. J Clin Oncol 24:3756–3762

    Article  PubMed  CAS  Google Scholar 

  21. Wiedswang G, Borgen E, Schirmer C et al (2005) Comparison of the clinical significance of occult tumor cells in blood and bone marrow in breast cancer. Int J Cancer 118:2013–2019

    Article  Google Scholar 

  22. Ring A, Smith I, Dowsett M (2004) Circulating tumour cells in breast cancer. Lancet 5:79–84

    Article  Google Scholar 

  23. Cristofanilli M, Hayes D, Budd T et al (2005) Circulating tumor cells: a novel prognostic factor for newly diagnosed metastatic breast cancer. J Clin Oncol 23:1420–1430

    Article  PubMed  Google Scholar 

  24. Cristofanilli M, Broglio K, Guarneri V et al (2007) Circulating tumor cells in metastatic breast cancer: biologic staging beyond tumor burden. Clin Breast Cancer 7:471–479

    Article  PubMed  Google Scholar 

  25. Gasent Blesa J, Alberola Candel V, Esteban González E et al (2008) Circulating tumor cells in breast cancer: methodology and clinical repercussions. Clin Transl Oncol 10:399–406

    Article  PubMed  CAS  Google Scholar 

  26. Bear H (2008) Measuring circulating tumor cells as a surrogate end point for adjuvanttherapy of breast cancer: what do they mean and what should we do about them? J Clin Oncol 26:1195–1197

    Article  PubMed  Google Scholar 

  27. Gervasoni A, Monasterio Muñoz R, Wengler G et al (2008) Molecular signature detection of circulating tumor cells using a panel of selected genes. Cancer Lett 263:267–279

    Article  PubMed  CAS  Google Scholar 

  28. Wang J, Wu C, Lu C et al (2006) Molecular detection of circulating tumor cells in the peripheral blood of patients with colorectal cancer using RTPCR: significance of the prediction of postoperative metastasis. World J Surg 30:1007–1013

    Article  PubMed  Google Scholar 

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Correspondence to María José Serrano.

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Serrano, M.J., Lorente, J.A., Rodríguez, M.D. et al. Circulating tumour cells in peripheral blood: potential impact on breast cancer outcome. Clin Transl Oncol 13, 204–208 (2011). https://doi.org/10.1007/s12094-011-0641-x

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  • DOI: https://doi.org/10.1007/s12094-011-0641-x

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