CTC count is an independent and quantitative prognostic factor in early breast cancer patients treated by NCT. It complements current prognostic models based on tumor characteristics and response to therapy.

Purpose: There is a need for sensitive, reproducible biomarkers for patients with stage III melanoma to guide clinical decision making. Circulating tumor cells (CTCs) can be detected in patients with melanoma; however, there are limited data regarding their significance in stage III disease. The aim of this study was to determine whether CTCs are associated with early relapse in stage III melanoma.Experimental Design: We prospectively assessed CTCs at first presentation in clinic (baseline) for 243 patients with stage III melanoma. CTCs were measured using the CellSearch System. Relapse-free survival (RFS) was compared between patients with one or more baseline CTC versus those with no CTCs. Log-rank test and Cox regression analysis were applied to establish associations of CTCs with RFS.Results: At least one baseline CTC was identified in 90 of 243 (37%) patients. Forty-five (19%), 67 (28%), 118 (49%), and 13 (5%) patients were stage IIIA, IIIB, IIIC, or IIID, respectively. CTC detection was not associated with substage, or primary tumor characteristics. Multivariable analysis demonstrated that the detection of ≥1 baseline CTC was significantly associated with decreased 6-month RFS [log-rank, P < 0.0001; HR, 3.62, 95% confidence interval (CI), 1.78-7.36; P < 0.0001] and 54-month RFS (log-rank, P ¼ 0.01; HR, 1.69; 95% CI, 1.13-2.54; P ¼ 0.01).Conclusions: ≥1 CTC was independently associated with melanoma relapse, suggesting that CTC assessment may be useful to identify patients at risk for relapse who could derive benefit from adjuvant therapy.

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Background Circulating tumor cells (CTCs) can be identified in approximately 25% of non-metastatic breast cancer patients (BC), and data are emerging regarding their prognostic significance. We hypothesized that CTCs identified prior to resection of the primary tumor would predict worse outcome in non-metastatic BC patients. Study Design We performed CTC enumerations on 509 patients with non-metastatic BC as part of an IRB approved study. CTCs (per 7.5 ml blood) were identified using the Cell Search® System (Janssen). The presence of ≥ 1 CTC meeting morphological criteria for malignancy was considered a positive result. Log-rank test and Cox regression analysis were applied to establish the association of CTCs with relapse-free and overall survival. Results Median follow-up was 48 months and mean age was 53 years. Fifty-nine percent of patients (299/509) had tumors >2cm, and 46% (234/509) had positive lymph nodes. One hundred sixty-six patients received neoadjuvant chemotherapy (NACT) prior to CTC assessment, and 343 patients were chemonaïve. One or more CTC was identified in 43/166 (26%) of NACT treated patients, and in 81/343 (24%) of chemonaïve patients. CTCs were not associated with tumor size, grade, or lymph node status (P= NS). Detection of one or more CTCs predicted decreased relapse-free (log-rank P<0.001, HR = 2.72, 95% CI, 1.57 to 4.72; P<0.001) and overall survival (log-rank P=0.02, HR = 2.29, 95% CI, 1.12 to 4.67; P = 0.03) at 48 months of follow-up. Conclusions One or more CTCs identified prior to resection of the primary breast tumor predicted worse relapse-free and overall survival, irrespective of primary tumor size, grade, or lymph node positivity.