Circulating tumour cells are associated with increased risk of venous thromboembolism in metastatic breast cancer patients

Abstract

BACKGROUND: Cancer is a risk factor for venous thromboembolism (VTE). Circulating tumour cells (CTCs) are an independent predictor of survival in metastatic breast cancer (MBC) patients. The aim of this study was to test the hypothesis that CTCs are associated with the risk of VTE in MBC patients. METHODS: This retrospective study included 290 MBC patients treated in the MD Anderson Cancer Center from January 2004 to December 2007. Circulating tumour cells were detected and enumerated using the CellSearch system before starting new lines of therapy. RESULTS: At a median follow-up of 12.5 months, 25 patients experienced VTE and 53 patients died without experiencing thrombosis. Cumulative incidence of thrombosis at 12 months was 8.5% (95% confidence interval (CI) ¼ 5.5%, 12.4%). Patients with CTCs X1 and X5 had a higher incidence of VTE compared with patients with 0 and o5 CTCs (12-month estimate, 11.7 and 11.6% vs 3 and 6.6%; P ¼ 0.006 and P ¼ 0.076, respectively). In the multivariate model, patients with CTCsX1 had a hazard ratio of VTE of 5.29 (95% CI ¼ 1.58, 17.7, P ¼ 0.007) compared with patients with no CTCs. CONCLUSION: These results suggest that CTCs in MBC patients are associated with increased risk of VTE. These patients should be followed up more closely for the risk of VTE.

Changes in the expression of plasma proteins associated with thrombosis in BRCA1 mutation carriers

“…Plasma level of apolipoprotein A-IV was found signiWcantly decrease in BRCA1 carriers compared to non-mutant controls. A previous study had reported an augmented expression of apolipoprotein A-IV in plasma from women with breast cancer (Mego et al 2009). However, there are also a great number of studies in diVerent types of cancer that support our results about apolipoprotein A-IV expression.…”

“…Taken together, these Wndings may suggest association between BRCA1 mutations and modiWcation in circulating biomarkers associated with predisposition of platelets to be activated. Accordingly, breast cancer has been associated with both arterial and venous thrombotic events (Mego et al 2009;Bourdeanu and Luu 2010). Some of the arterial and venous thrombotic events associated with breast cancer were attributed to inserted venous catheters, in patients receiving chemotherapy, to tamoxifen treatment, and to adjuvant chemotherapy treatment between others (Tesselaar et al 2004;Osborne 1998;Saphner et al 1991).…”

Characterization of microfluidic shear-dependent epithelial cell adhesion molecule immunocapture and enrichment of pancreatic cancer cells from blood cells with dielectrophoresis

“…11,13,[17][18][19][20][21][22][23] However, EpCAM varies in expression level between cancers and potentially fails to capture more invasive CTCs that have undergone the epithelial-to-mesenchymal transition (EMT). [24][25][26] Despite differences in cell surface antigen expression levels, a majority of cancer cells are vastly different from blood cells in cellular composition and morphology, which leads to their distinct electrical properties and dielectrophoretic response. 27 Therefore, we hypothesize that dielectrophoresis (DEP) can potentially be used to capture cancer cells that are less likely to be isolated by traditional immunocapture methods with epithelial markers such as EpCAM.…”

Feared complication of malignancy: Venous thromboembolism

“…Kansere bağlı tromboembolik hastalıkların gelişiminde, kanser hücrelerinden salgılanan prokoagülan moleküller, tedavide büyük cerrahi girişimlerin uygulanması, hastanede yatış süresinin uzamış olması, santral venöz kateter kullanımı, kemoterapi ve hormonal tedaviler gibi risk faktörleri mevcuttur (15)(16)(17)(18)(19)(20)(21)(22). Kanser hücrelerinin VTE insidansını arttırmasının patogenetik mekanizmaları yüzyıldan fazla bir zaman önce Virchow tarafınca ortaya konmuştur.…”