Circulating Tumor Cells in Breast Cancer Patients Treated by Neoadjuvant Chemotherapy: A Meta-analysis

Bidard, François-Clément; Michiels, Stefan; Riethdorf, Sabine; Mueller, Volkmar; Esserman, Laura J.; Lucci, Anthony; Naume, Bjørn; Horiguchi, Jun; Gisbert-Criado, Rafael; Sleijfer, Stefan; Toi, Masakazu; García-Sáenz, José Á.; Hartkopf, Andreas D.; Generali, Daniele; Rothé, Françoise; Smerage, Jeffrey B.; Muinelo‐Romay, Laura; Stebbing, Justin; Viens, Patrice; Magbanua, Mark Jesus M.; Hall, Carolyn; Engebraaten, Olav; Takata, Daisuke; Vidal-Martínez, José; Onstenk, Wendy; Fujisawa, Noriyoshi; Dı́az-Rubio, Eduardo; Taran, Florin‐Andrei; Cappelletti, Maria Rosa; Ignatiadis, Michail; Proudhon, Charlotte; Wolf, Denise M.; Bauldry, Jessica B.; Borgen, Elin; Nagaoka, Rin; Carañana, Vicente; Kraan, Jaco; Maestro, Marisa; Brucker, Sara Y.; Weber, Karsten E.; Reyal, Fabien; Amara, Dominic; Karhade, Mandar; Mathiesen, Randi R.; Tokiniwa, Hideaki; Llombart-Cussac, Antonio; Meddis, Alessandra; Blanche, Paul; D’Hollander, Koenraad; Cottu, Paul; Park, John W.; Loibl, Sibylle; Latouche, Aurélien; Pierga, Jean‐Yves; Pantel, Klaus

doi:10.1093/jnci/djy018

Cited by 227 publications

(206 citation statements)

References 20 publications

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“…In addition, an in vivo animal experiment also indicated that NCT could promote luminal BC cell intrusion into the circulation . On the other hand, a meta‐analysis included 1574 BC patients who underwent NCT and evaluated the CTC numbers with CellSearch at baseline and before surgery; although there was no significant correlation between the pCR and CTC detection before surgery, the CTC count was lower than the baseline count ( P < .001) . Here, our results also revealed that CTC numbers decreased with NCT, and we did not find a definite correlation between CTC changes and the pCR rate, but the patients with positive CTCs at baseline and converted to negative CTCs after NCT had a higher pCR ratio compared to that in patients in the other groups, which suggested a potential pCR predictive value of CTC numeration in patients with CTCs detected before NCT.…”

Section: Discussionmentioning

confidence: 50%

“…In addition, recent reports indicate that patients who receive NCT and have residual disease could benefit from following intensive or prolonged treatment . Multiple approaches have been applied to investigate the effectiveness of NCT, such as Ki67, MRI, and PET scanning, while the potential value of CTC in NCT of BC has only been reported in a few studies …”

Section: Introductionmentioning

confidence: 99%

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Prospective study of the relevance of circulating tumor cell status and neoadjuvant chemotherapy effectiveness in early breast cancer

Fang

Zhang

et al. 2020

Cancer Medicine

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Although unequivocal evidence has shown the prognostic relevance of circulating tumor cells (CTCs) in patients with metastatic breast cancer (MBC), less evidence is available for its significance in neoadjuvant chemotherapy (NCT) in early breast cancer (BC). Here we conducted an analysis of individual data from 86 patients confirmed as invasive BC by core‐needle biopsy in Zhejiang Provincial People's Hospital between June 2013 and January 2017. The CTCs were assessed at the time after diagnosis and before surgery with the CanPatrol technique. The median follow‐up duration was 46.3 months. CTCs were detected in 37.2% of all patients (29/78) at baseline, and the presence of CTCs was associated with tumor size, tumor stage, and molecular classification. After NCT, the CTC‐positive patients were dropped from 29 to 8, and the EC‐T (epirubicin/cyclophosphamide followed by docetaxel) and TEC (docetaxel/epirubicin/cyclophosphamide) strategies reduce CTC‐positive patients from 16 to 3 and 13 to 5, respectively. The CTC‐negative conversion rates were similar in ER/PR+ HER2+ (5/7, 71.4%), ER/PR− HER2+ (8/11, 72.7%), and TNBC (7/10, 70%) during NCT. In addition, we explored the association between CTC‐negative conversion and objective response rate (partial response and complete response, ORR) and pathological complete response rate (pCR), and our results indicate that ORR was higher in patients with positive CTCs and converted to negative after NCT (ORR, P = .013; pCR, P = .0608). Our study preliminarily highlights the relevance of CTC status and NCT effectiveness in early BC using the CanPatrol system.

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Section: Discussionmentioning

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Prospective study of the relevance of circulating tumor cell status and neoadjuvant chemotherapy effectiveness in early breast cancer

Fang

Zhang

et al. 2020

Cancer Medicine

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“…The clinical utility of CTC enumeration as a prognostic marker in nonmetastatic breast cancer patients treated by neoadjuvant chemotherapy was recently shown in a meta‐analysis using the CellSearch system. This meta‐analysis, based on 21 studies, has shown that CTC count is an independent and quantitative prognostic factor in early breast cancer patients treated by neoadjuvant chemotherapy, and complements current prognostic models based on tumor characteristics and response to therapy . A very recent clinical prospective study that included 156 women with newly diagnosed metastatic breast cancer concluded that longitudinal evaluation of CTC and CTC clusters improves prognostication and monitoring in patients with metastatic breast cancer starting first‐line systemic therapy …”

Section: Circulating Tumor Cellsmentioning

confidence: 79%

“…This meta-analysis, based on 21 studies, has shown that CTC count is an independent and quantitative prognostic factor in early breast cancer patients treated by neoadjuvant chemotherapy, and complements current prognostic models based on tumor characteristics and response to therapy. 39 A very recent clinical prospective study that included 156 women with newly diagnosed metastatic breast cancer concluded that longitudinal evaluation of CTC and CTC clusters improves prognostication and monitoring in patients with metastatic breast cancer starting first-line systemic therapy. 40 Detection of CTCs using the CellSearch system before neoadjuvant therapy was an independent prognostic factor of impaired clinical outcome, and when combined with pathologic complete response (pCR), it was shown to be helpful to stratify breast cancer patients for therapeutic interventions.…”

Section: Breast Cancermentioning

confidence: 99%

Liquid biopsies

Lianidou

Pantel

2019

Genes Chromosomes & Cancer

Self Cite

127

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Liquid biopsy is based on minimally invasive blood tests and has a high potential to significantly change the therapeutic strategy in cancer patients, providing an extremely powerful and reliable noninvasive clinical tool for the individual molecular profiling of patients in real time. Liquid biopsy approaches include the analysis of circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), circulating miRNAs, and tumor‐derived extracellular vesicles (EVs) that are shed from primary tumors and their metastatic sites into peripheral blood. The major advantage of liquid biopsy analysis is that it is minimally invasive, and can be serially repeated, thus allowing extracting information from the tumor in real time. Moreover, the identification of predictive biomarkers in peripheral blood that can monitor response to therapy in real time holds a very strong potential for novel approaches in the therapeutic management of cancer patients. In this review, we summarize recent knowledge on CTCs and ctDNA and discuss future trends in the field.

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“…For example, some experimental approaches utilize the detection of circulating microRNAs owing to their relatively good stability in body fluids. In addition, a number of investigational diagnostic procedures rely on the isolation and analysis of circulating tumor cells (Antonarakis et al, 2014; Dasgupta et al, 2017; Siravegna et al, 2017; Bidard et al, 2018). …”

Section: Liquid Biopsymentioning

confidence: 99%

Molecular Diagnostics in Clinical Oncology

Sokolenko

Imyanitov

2018

Front. Mol. Biosci.

108

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There are multiple applications of molecular tests in clinical oncology. Mutation analysis is now routinely utilized for the diagnosis of hereditary cancer syndromes. Healthy carriers of cancer-predisposing mutations benefit from tight medical surveillance and various preventive interventions. Cancers caused by germ-line mutations often require significant modification of the treatment strategy. Personalized selection of cancer drugs based on the presence of actionable mutations has become an integral part of cancer therapy. Molecular tests underlie the administration of EGFR, BRAF, ALK, ROS1, PARP inhibitors as well as the use of some other cytotoxic and targeted drugs. Tumors almost always shed their fragments (single cells or their clusters, DNA, RNA, proteins) into various body fluids. So-called liquid biopsy, i.e., the analysis of circulating DNA or some other tumor-derived molecules, holds a great promise for non-invasive monitoring of cancer disease, analysis of drug-sensitizing mutations and early cancer detection. Some tumor- or tissue-specific mutations and expression markers can be efficiently utilized for the diagnosis of cancers of unknown primary origin (CUPs). Systematic cataloging of tumor molecular portraits is likely to uncover a multitude of novel medically relevant DNA- and RNA-based markers.

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Circulating Tumor Cells in Breast Cancer Patients Treated by Neoadjuvant Chemotherapy: A Meta-analysis

Abstract: 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.

Cited by 227 publications

References 20 publications

Prospective study of the relevance of circulating tumor cell status and neoadjuvant chemotherapy effectiveness in early breast cancer

Prospective study of the relevance of circulating tumor cell status and neoadjuvant chemotherapy effectiveness in early breast cancer

Liquid biopsies

Molecular Diagnostics in Clinical Oncology

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