Note the findings apply primarily to node negative patients:
10 May 2007
Ann Oncol 2007;
18: 851–858
MedWire News: Detecting circulating tumor cells (CTCs) expressing HER2 messenger RNA (mRNA) in breast cancer patients after the completion of adjuvant chemotherapy may offer useful information on the efficacy of treatment and the patients’ prognosis, conclude Greek scientists.
Patients with stage I and II breast cancer who are otherwise free of metastases may have tumor cells in bone marrow aspirates or the peripheral blood, say D Mavroudis, from University General Hospital of Heraklion, and colleagues.
To examine the prognostic value of CTCs expressing HER2 mRNA, the team performed nested real-time polymerase chain reaction assays on the peripheral blood of 214 patients with stage I and II breast cancer who had completed adjuvant chemotherapy.
In all, 21% of the patients were found to have HER2 mRNA-positive CTCs, including 5% of patients who were negative for them before chemotherapy, the team reports in the
Annals of Oncology. Interestingly, adjuvant chemotherapy eliminated HER2 mRNA-positive CTCs in 30.2% of patients who were positive for the cells before chemotherapy.
Detecting HER2 mRNA-positive CTCs after adjuvant chemotherapy was linked to a significant reduction in the disease-free interval, the team notes, although overall survival was unaffected. Further analysis revealed that these findings were largely confined to node-negative patients, despite some node-positive patients being affected.
Performing multivariate analysis indicated that detecting CTCs that expressed HER2 mRNA after adjuvant chemotherapy was an independent predictor of the length of the disease-free interval, at a hazard ratio of 3.238.
The team writes: “Since the presence of disseminated tumor cells and CTCs is clearly associated with worse prognosis, it should be of great importance to develop therapeutic approaches to target these cells before the development of overt metastases.”
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