Circulating Tumor Cells and [¹⁸F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Outcome Prediction in Metastatic Breast Cancer

Abstract

Detection of five or more CTCs during therapeutic monitoring can accurately predict prognosis in MBC beyond metabolic response. FDG-PET/CT deserves a role in patients who have fewer than five CTCs at midtherapy. Prospective trials should evaluate the most sensitive and cost-effective modality for therapeutic monitoring in MBC.

Prognostic Significance of Circulating Tumor Cells and Serum CA15-3 Levels in Metastatic Breast Cancer, Single Center Experience, Preliminary Results

“…In a study where response to chemotherapy was assessed every three months using CTC count and PET CT in metastatic disease, CTC response was consistent with the radiologic response evaluated by PET CT in 67% of the measurements. CTC response was determined as an independent risk factor for OS in multivariate analysis (De Giorgi et al, 2009). A relationship between CTC count and metastatic site was not observed in this study.…”

“…Age at diagnosis, hormone receptor status, c-erbB2 status, lymph node metastasis are among prognostic factors of BC (Andreopoulou et al, 2008). Another prognostic factor described for the BC is the number of CTC (Cristofanilli et al, 2004;Budd et al, 2006;Hayes et al, 2006;Cristofanilli et al, 2007;Harris et al, 2007;Dawood et al, 2008;De Giorgi et al, 2009). Moreover it is suggested that CTC may be predictively effective for the evaluation of the response to the treatment (Tewes et al, 2009).…”

Modeling the relationship between circulating tumour cells number and prognosis of metastatic breast cancer

“…Studies in metastatic breast, colorectal, and prostate cancer showed that patients about to start new lines of chemotherapy could be divided into groups with favourable and unfavourable prognosis on the basis of the number of CTCs measured with the analytically valid CellSearch system(Veridex, Raritan, NJ, USA) [3,[5][6][7][8][9][10][11][12][13]20]. When studying the association between the number of CTCs and evolution of the disease, researchers generally use a single cutpoint to identify favorable and unfavorable response groups, such as 5 CTCs for MBC [3,4,14], three for metastatic colorectal cancer [11], and five for castration resistant prostate cancer [7]. Dichotomization is very common in clinical studies, since it satisfies the general need in clinical practice to label individuals as having or not having a characteristic and to decide the treatment strategy.…”

“…For example, in studies on MBC, a cutpoint of 5 CTCs has been generally adopted [3,4,13,14]. Dichotomization has some perceived advantages, such as simplicity, easy interpretation of the results, and functionality in clinical practice, but also some intrinsic problems, such as loss of information and statistical power, increased probability of false positive results, and impossibility of detecting nonlinear relationships between the predictor and the outcome [15][16][17][18].…”

Minimal Residual Disease and Circulating Tumor Cells in Breast Cancer

“…CTC detection was an independent predictor of progressionfree survival and overall survival [10]. Th is and other studies [49][50][51][52] have provided solid data about the adverse prognostic value when CTCs are detected by CellSearch® in metastatic BC.…”