CTC Levels Predict Outcome in Metastatic Breast Cancer

A high level of circulating tumor cells (CTC) predicted a poor outcome for breast cancer patients.

Scientists prospectively tested CTCs as an outcome predictor compared with serum tumor markers in metastatic breast cancer patients treated by first-line chemotherapy.

The study included 267 patients with metastatic breast cancer who were receiving first-line chemotherapy and had undergone assessment for three tumor markers: CA 15.3, CEA, and lactate dehydrogenase (LDH). Patients were enrolled in one of five cancer centers in France between June 2007 and September 2009, and were followed for a median of 16 months.

Sixty-five percent of the patients had one or more CTCs; 44 % had five or more CTCs. Of the measured tumor markers, 64 % of patients had high CA 15.3, 51 % had high CEA, and 45 % had high LDH.

Evaluation of serum tumor markers showed that baseline levels of CA 15.3, CEA, and LDH were prognostic for poor progression-free survival, but only LDH was prognostic for overall survival. CTCs were highly associated with tumor markers, tumor burden, performance status, and number of metastatic sites, but were also independent of tumor biology, such as HER2 status, or grade of cancer.

Jean-Yves Pierga, MD, PhD, professor of the medical oncology department, Institut Curie (Paris, France) and Université Paris Descartes, (France) presented the results of this study at the 33rd Annual Cancer Therapy and Research Center-American Association for Cancer Research (CTRC-AACR) San Antonio Breast Cancer Symposium, held December 8-12, 2010, in Texas, (USA).

"CTCs add an independent prognostic marker in metastatic breast cancer at first-line chemotherapy, and an early predictive marker of clinical benefit after one cycle of chemotherapy," concluded Prof. Pierga.

Related Links:
Institut Curie
Université Paris Descartes
CTRC-AACR San Antonio Breast Cancer Symposium