TY - JOUR
T1 - Circulating tumor cells in breast cancer patients treated by neoadjuvant chemotherapy
T2 - A Meta-analysis
AU - Bidard, François Clement
AU - Michiels, Stefan
AU - Riethdorf, Sabine
AU - Mueller, Volkmar
AU - Esserman, Laura J.
AU - Lucci, Anthony
AU - Naume, Bjørn
AU - Horiguchi, Jun
AU - Gisbert-Criado, Rafael
AU - Sleijfer, Stefan
AU - Toi, Masakazu
AU - Garcia-Saenz, Jose A.
AU - Hartkopf, Andreas
AU - Generali, Daniele
AU - Rothe, Françoise
AU - Smerage, Jeffrey
AU - Muinelo-Romay, Laura
AU - Stebbing, Justin
AU - Viens, Patrice
AU - Magbanua, Mark Jesus M.
AU - Hall, Carolyn S.
AU - Engebraaten, Olav
AU - Takata, Daisuke
AU - Vidal-Martınez, Jose
AU - Onstenk, Wendy
AU - Fujisawa, Noriyoshi
AU - Diaz-Rubio, Eduardo
AU - Taran, Florin Andrei
AU - Cappelletti, Maria Rosa
AU - Ignatiadis, Michail
AU - Proudhon, Charlotte
AU - Wolf, Denise M.
AU - Bauldry, Jessica B.
AU - Borgen, Elin
AU - Nagaoka, Rin
AU - Carañana, Vicente
AU - Kraan, Jaco
AU - Maestro, Marisa
AU - Brucker, Sara Yvonne
AU - Weber, Karsten
AU - Reyal, Fabien
AU - Amara, Dominic
AU - Karhade, Mandar G.
AU - Mathiesen, Randi R.
AU - Tokiniwa, Hideaki
AU - Llombart-Cussac, Antonio
AU - Meddis, Alessandra
AU - Blanche, Paul
AU - D'Hollander, Koenraad
AU - Pantel, Klaus
N1 - Publisher Copyright:
© The Author 2017. Published by Oxford University Press.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Background: We conducted a meta-analysis in nonmetastatic breast cancer patients treated by neoadjuvant chemotherapy (NCT) to assess the clinical validity of circulating tumor cell (CTC) detection as a prognostic marker. Methods: We collected individual patient data from 21 studies in which CTC detection by CellSearch was performed in early breast cancer patients treated with NCT. The primary end point was overall survival, analyzed according to CTC detection, using Cox regression models stratified by study. Secondary end points included distant disease-free survival, locoregional relapse-free interval, and pathological complete response. All statistical tests were two-sided. Results: Data from patients were collected before NCT (n ¼ 1574) and before surgery (n ¼ 1200). CTC detection revealed one or more CTCs in 25.2% of patients before NCT; this was associated with tumor size (P < .001). The number of CTCs detected had a detrimental and decremental impact on overall survival (P < .001), distant disease-free survival (P < .001), and locoregional relapse-free interval (P < .001), but not on pathological complete response. Patients with one, two, three to four, and five or more CTCs before NCT displayed hazard ratios of death of 1.09 (95% confidence interval [CI] ¼ 0.65 to 1.69), 2.63 (95% CI ¼ 1.42 to 4.54), 3.83 (95% CI ¼ 2.08 to 6.66), and 6.25 (95% CI ¼ 4.34 to 9.09), respectively. In 861 patients with full data available, adding CTC detection before NCT increased the prognostic ability of multivariable prognostic models for overall survival (P < .001), distant disease-free survival (P < .001), and locoregional relapse-free interval (P ¼ .008). Conclusions: 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.
AB - Background: We conducted a meta-analysis in nonmetastatic breast cancer patients treated by neoadjuvant chemotherapy (NCT) to assess the clinical validity of circulating tumor cell (CTC) detection as a prognostic marker. Methods: We collected individual patient data from 21 studies in which CTC detection by CellSearch was performed in early breast cancer patients treated with NCT. The primary end point was overall survival, analyzed according to CTC detection, using Cox regression models stratified by study. Secondary end points included distant disease-free survival, locoregional relapse-free interval, and pathological complete response. All statistical tests were two-sided. Results: Data from patients were collected before NCT (n ¼ 1574) and before surgery (n ¼ 1200). CTC detection revealed one or more CTCs in 25.2% of patients before NCT; this was associated with tumor size (P < .001). The number of CTCs detected had a detrimental and decremental impact on overall survival (P < .001), distant disease-free survival (P < .001), and locoregional relapse-free interval (P < .001), but not on pathological complete response. Patients with one, two, three to four, and five or more CTCs before NCT displayed hazard ratios of death of 1.09 (95% confidence interval [CI] ¼ 0.65 to 1.69), 2.63 (95% CI ¼ 1.42 to 4.54), 3.83 (95% CI ¼ 2.08 to 6.66), and 6.25 (95% CI ¼ 4.34 to 9.09), respectively. In 861 patients with full data available, adding CTC detection before NCT increased the prognostic ability of multivariable prognostic models for overall survival (P < .001), distant disease-free survival (P < .001), and locoregional relapse-free interval (P ¼ .008). Conclusions: 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.
UR - http://www.scopus.com/inward/record.url?scp=85051841054&partnerID=8YFLogxK
U2 - 10.1093/jnci/djy018
DO - 10.1093/jnci/djy018
M3 - Article
C2 - 29659933
AN - SCOPUS:85051841054
SN - 0027-8874
VL - 110
SP - 560
EP - 567
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 6
ER -