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

Fang, Qing‐Qing; Zhang, Min; Zhang, Jingxia; Zhong, Miaochun; Zheng, Yajuan

doi:10.1002/cam4.2876

Cited by 8 publications

(6 citation statements)

References 53 publications

(100 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The changing profile of metastatic potential (CTCs) and host immunity (CAMLs) over the course of treatment might be valuable for predicting pCR in the NAC setting using routine blood draws. Few studies have been done to correlate CTCs with OS and DFS in breast cancer patients undergoing NAC [ 43 , 44 , 45 , 46 , 47 ]. One study isolated E + CTCs before and after NAC and found that triple-negative and HER2-positive cancers were associated with worse OS and DFS if they had ≥2 CTCs/7.5 mL of blood before NAC [ 43 ].…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Profiling of Cancer-Associated Cells in the Blood of Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy to Predict Pathological Complete Response

et al. 2023

View full text Add to dashboard Cite

Neoadjuvant chemotherapy (NAC) can affect pathological complete response (pCR) in breast cancers; the resection that follows identifies patients with residual disease who are then offered second-line therapies. Circulating tumor cells (CTCs) and cancer-associated macrophage-like cells (CAMLs) in the blood can be used as potential biomarkers for predicting pCR before resection. CTCs are of epithelial origin that undergo epithelial-to-mesenchymal transition to become more motile and invasive, thereby leading to invasive mesenchymal cells that seed in distant organs, causing metastasis. Additionally, CAMLs in the blood of cancer patients are reported to either engulf or aid the transport of cancer cells to distant organs. To study these rare cancer-associated cells, we conducted a preliminary study where we collected blood from patients treated with NAC after obtaining their written and informed consent. Blood was collected before, during, and after NAC, and Labyrinth microfluidic technology was used to isolate CTCs and CAMLs. Demographic, tumor marker, and treatment response data were collected. Non-parametric tests were used to compare pCR and non-pCR groups. Univariate and multivariate models were used where CTCs and CAMLs were analyzed for predicting pCR. Sixty-three samples from 21 patients were analyzed. The median(IQR) pre-NAC total and mesenchymal CTC count/5 mL was lower in the pCR vs. non-pCR group [1(3.5) vs. 5(5.75); p = 0.096], [0 vs. 2.5(7.5); p = 0.084], respectively. The median(IQR) post-NAC CAML count/5 mL was higher in the pCR vs. non-pCR group [15(6) vs. 6(4.5); p = 0.004]. The pCR group was more likely to have >10 CAMLs post-NAC vs. non-pCR group [7(100%) vs. 3(21.4%); p = 0.001]. In a multivariate logistic regression model predicting pCR, CAML count was positively associated with the log-odds of pCR [OR = 1.49(1.01, 2.18); p = 0.041], while CTCs showed a negative trend [Odds Ratio (OR) = 0.44(0.18, 1.06); p = 0.068]. In conclusion, increased CAMLs in circulation after treatment combined with lowered CTCs was associated with pCR.

show abstract

Section: Introductionmentioning

confidence: 99%

Comprehensive Profiling of Cancer-Associated Cells in the Blood of Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy to Predict Pathological Complete Response

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Until recently, no association between CTC detection prior to neoadjuvant therapy and pathological response in early breast cancer has been shown (23,29). Recent evidence suggests conversion from CTC positive to CTC negative state after neoadjuvant therapy may be associated with some degree of pathological response (64). As this was a preliminary study in a small patient cohort, no extended protocol was in place to investigate prognostic relevance or monitor CTC dynamics longitudinally to make our data comparable to published literature.…”

Section: Discussionmentioning

confidence: 69%

“…Our study found no clinicopathological correlations with the presence of canonical or non-canonical CTCs before neoadjuvant setting, and no impact of detected CTCs on pCR. Published literature has shown correlations with tumor size ( 23 , 64 ), tumor stage, and molecular classification ( 64 ). Until recently, no association between CTC detection prior to neoadjuvant therapy and pathological response in early breast cancer has been shown ( 23 , 29 ).…”

Section: Discussionmentioning

confidence: 99%

Preclinical and Clinical Evaluation of Magnetic-Activated Cell Separation Technology for CTC Isolation in Breast Cancer

et al. 2020

View full text Add to dashboard Cite

Circulating tumor cell (CTC) count is an independent prognostic factor in early breast cancer. CTCs can be found in the blood of 20% of patients prior to neoadjuvant therapy. We aimed to assess the suitability of magnetic-activated cell separation (MACS) technology for isolation and cytological characterization of CTCs. In the preclinical part of the study, cell lines were spiked into buffy coat samples derived from healthy donors, and isolated using MACS. Breast cancer cells with preserved cell morphology were successfully isolated. In the clinical part, blood for CTC isolation was drawn from 44 patients with early and locally advanced breast cancer prior to neoadjuvant chemotherapy. Standard Giemsa, Papanicolaou and pancytokeratin staining was applied. 2.3% of samples contained cells that meet both the morphological and immunocytochemical criteria for CTC. In 32.6% of samples, partially degenerated pancytokeratin negative cells with morphological features of tumor cells were observed. In 65.1% of samples, CTCs were not found. In conclusion, our results demonstrate that morphologically intact tumor cells can be isolated using MACS technology. However, morphologically intact tumor cells were not detected in the clinical part of the study. At present, MACS technology does not appear suitable for use in a clinical cytopathology laboratory.

show abstract

“…A study enrolled 86 early breast cancer patients and detected CTCs in 37.2% of cases, of which CTCs were correlated with tumor size, stage, molecular classification and preliminarily indicating the association of EMT CTCs and neoadjuvant chemotherapy effectiveness. 18 In a study with 651 localized colorectal cancer patients, CTCs were found in 535 patients, including 461 cases with the biophenotypic subtype, which associated with clinical stage. 19 The EMT CTC subtypes also correlated with disease progression and poor prognosis in early stage lung cancer and cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

<p>Prospective Study of the Clinical Impact of Epithelial and Mesenchymal Circulating Tumor Cells in Localized Prostate Cancer</p>

Liu¹,

Ding²,

Wu³

et al. 2020

CMAR

View full text Add to dashboard Cite

Background: Although circulating tumor cells (CTCs) are considered as a surrogate marker in monitoring disease progression and treatment response in late stage prostate cancer (PCa), its clinical impact in localized PCa remains unclear, indicating the limitation that is simply based on cell count. This perspective observational study aimed to detect the epithelial-to-mesenchymal transition (EMT) subtypes of CTCs in localized PCa and analyze their clinical relevance and application in predicting PCa stages before surgery compared with the Partin table.Patients and Methods: Between August 2017 and April 2019, 80 newly diagnosed localized PCa patients were enrolled in the study. Peripheral blood samples (5 mL) were collected prior to surgery. The CanPatrol TM CTC enrichment technique, a size-based isolation method, was used to detect the EMT CTCs. Clinical relevance of the CTCs was analyzed with Spearman's rank correlation test. Models to predict pathological were built with multivariate logistic regression. Receiver operating characteristic (ROC) curve and area under the curve (AUC) analysis were performed to evaluate the accuracy of the prediction model. Results: CTCs were detected in 55% of all patients. The biophenotypic CTCs were most valuable and closely correlated with PSA, Gleason score, D'Amico risk classification, and pathological stage in localized PCa. The mesenchymal subtype was rare in this population but associated with seminal vesicle invasion, while the epithelial subtype had limited clinical significance. In addition, the biophenotypic CTCs combined with traditional clinical variables were analyzed by multivariate logistic regression to predict organ-confined disease before surgery, of which the AUC reached 0.818 and was superior to the Partin table 2017 in our cohort. Conclusion: This study highlights the clinical impact of the biophenotypic CTCs in localized PCa, which was most closely related to clinical variables and could help to predict pathology outcomes before surgery.

show abstract

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

Cited by 8 publications

References 53 publications

Comprehensive Profiling of Cancer-Associated Cells in the Blood of Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy to Predict Pathological Complete Response

Comprehensive Profiling of Cancer-Associated Cells in the Blood of Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy to Predict Pathological Complete Response

Preclinical and Clinical Evaluation of Magnetic-Activated Cell Separation Technology for CTC Isolation in Breast Cancer

<p>Prospective Study of the Clinical Impact of Epithelial and Mesenchymal Circulating Tumor Cells in Localized Prostate Cancer</p>

Contact Info

Product

Resources

About