Correlation of hormone receptor status between circulating tumor cells, primary tumor, and metastasis in breast cancer patients

Abstract

PURPOSE Estrogen receptor (ER) and progesterone receptor (PR) status is prognostic and predictive in breast cancer. Because metastatic breast tumor biopsies are not routinely feasible, circulating tumor cells (CTCs) offer an alternative source of determining ER/PR tumor status. METHODS/PATIENTS Peripheral blood was collected prospectively from 36 patients with metastatic breast cancer. CTCs were isolated using the microfluidic OncoCEE™ platform. Detection was accomplished with an expanded anti-cytokeratin (CK) cocktail mixture and anti-CD45. ER/PR protein expression was assessed by immunocytochemistry (ICC) on the CK+ cells and compared to the primary and/or metastatic tumor (immunohistochemistry: IHC). RESULTS Among the 24 CK+ CTC cases, a concordance of 68% (15/22) in ER/PR status between primary breast tumor and CTCs and 83% (10/12) between metastatic tumor and CTCs was observed. An overall concordance of 79% (19/24) was achieved when assessing CTC and metastatic tumor (primary tumor substituted if metastatic breast biopsy not available). A test sensitivity of 72% and specificity of 100% was identified when comparing CTCs to tumor tissue. Of the 7 discordant cases between CTCs and primary tumor tissue, 2 were concordant with the metastatic biopsy. CONCLUSIONS CTC ER/PR status using the OncoCEE™ platform is feasible, with high concordance in ER/PR status between tumor tissue (IHC) and CTCs (ICC). The prognostic and predictive significance of CTC ER/PR protein expression needs further evaluation in larger trials.

Circulating tumor cell-derived organoids: Current challenges and promises in medical research and precision medicine

“…CA15-3, GA 733-2, and Her2) [26–28]. OncoCEE (commercialized by Biocept) uses an anti-EpCAM antibody for capture and a cocktail of TROP-2, MUC-1, HER2, EGFR and N-cadherin antibodies for detection of CTCs [29]; this approach had high detection efficiency in samples from patients with metastatic breast cancer [30]. …”

Clinical Utility of Target Selector™ ctDNA Testing: Detection of EGFR Mutations via Liquid Biopsy Enabled Targeted Therapy Selection for Patients with Advanced NSCLC

“…Subsequent Sanger sequencing of the Target Selector™ amplicon identifies the specific mutation ( Figure 1) [6]. CTC isolation and enumeration were performed as described [7][8][9]. Captured CTCs were subsequently subjected to FISH analyses within the microchannel to identify ALK or ROS1 gene rearrangements.…”

Potential Role of Circulating Tumor Cell Detection and Monitoring in Breast Cancer: A Review of Current Evidence

“…According to numerous trials, the phenotype and genotype of primary tumor, metastatic lesion, and CTCs often differ (62–66). Hypothetically, CTCs represent the dominant tumor cell population in metastatic disease; therefore, their expression profile may predict therapeutic response most adequately (67).…”