It was suggested in a paper by Dr. Katharina Pachmann that was presented at a recent ASCO trade show, about combining molecular analysis, chemo sensitivity testing in vitro, and therapy monitoring in vivo on disseminated tumor cells (CTC) in breast cancer patients.
Dr. Katharina Pachmann was the investigator who reported at an annual San Antonio Breast Cancer Symposium in 2004, using the CTC technique, German investigators showing that neoadjuvant chemotherapy with paclitaxel (taxol) causes a massive release of cells into the circulation, while at the same time reducing the size of the tumor. The finding helped to explain the fact that complete pathologic responses do not correlate well with improvements in survival (Oncol News Int'l, Vol 14, #5, May '05).
Two years before this, Dr. Christos Kosmas, published a study "Carcinomatous Meningits: Taxane-Induced" which found what is called "dissemination after taxane-based (taxol) chemotherapy. the study concluded that Carcinomatous Meningitis (a CNS metastasis) after a major response to front-line taxane-based regimens represents a grave disease manifestation and its incidence appears increased when compared retrospectivley to non-taxane-treated patients (American Journal Clinical Oncology 2002;63:6-15).
Monitoring CTCs could be utilized for confirmation after the patient is administered assay-directed most beneficial therapeutic agents.
Combining molecular analysis, chemosensitivity testing in vitro, and therapy monitoring in vivo on disseminated tumor cells in breast cancer patients.
Sub-category: Tumor/Cell Biology
Category: Tumor Biology
Meeting: 2010 ASCO Annual Meeting
Session Type and Session Title: This abstract has been published in conjunction with the meeting.
Abstract No: e21116
Citation: J Clin Oncol 28, 2010 (suppl; abstr e21116)
Author(s): K. Pachmann, O. Camara, T. Kroll, S. Carl, N. Rüdiger, C. Rabenstein, A. Plaschke-Schluetter; University of Jena, Jena, Germany; Transfusion Center Bayreuth, Bayreuth, Germany; MMI AG, Zurich, Switzerland
Abstract
Background:
Most breast cancer patients do not die of their primary tumor but from metastases developing sometimes years after the primary tumor has been removed. Cells from the tumor seem to be disseminated continuously during tumor growth and the first spread of tumor cells detectable with conventional methods is in the lymph nodes. Patients with lymph node positive disease have a poorer disease free survival than patients without affected lymph nodes. An increase in circulating epithelial tumor cell (CETC) numbers during adjuvant therapy is correlated with an 11 to 16-fold increase in hazard of relapse indicating increasing resistance to the applied drugs. Therefore, it would be desirable to better characterize these cells, test them for alternate drugs and monitor the actual response to the therapy decided on.
Methods:
For this purpose we have developed a test system comprising isolation of individual CETC from lymph nodes and blood from breast cancer patients for molecular characterization, chemo sensitivity testing of cells from the same sample defining the effectivity of the drugs as percentage of cells killed and measurement of the response of the CETC to the drugs in these patients treated according to guide lines.
Results:
The molecular characteristics and the sensitivity to the applied drugs of the tested cells and the response of the CETC were subsequently compared to clinical outcome.
Conclusions:
The response of CETC to therapy correlated highly with the previously tested chemo sensitivity and the molecular characteristics of these cells. Correlation to relapse or progression free survival is under investigation.
http://abstract.asco.org/AbstView_74_52031.html