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presence of circulating tumor cells bad prognositic sign at any stage of mbctreatment
1: Clin Cancer Res. 2006 Jul 15;12(14):4218-24. Links
Circulating Tumor Cells at Each Follow-up Time Point during Therapy of Metastatic Breast Cancer Patients Predict Progression-Free and Overall Survival.
Hayes DF,
Cristofanilli M,
Budd GT,
Ellis MJ,
Stopeck A,
Miller MC,
Matera J,
Allard WJ,
Doyle GV,
Terstappen LW.
Authors' Affiliations: Department of Internal Medicine and the Comprehensive Cancer Center, University of Michigan Health and Hospital System, Ann Arbor, Michigan.
PURPOSE: We reported previously that >/=5 circulating tumor cells (CTC) in 7.5 mL blood at baseline and at first follow-up in 177 patients with metastatic breast cancer (MBC) were associated with poor clinical outcome. In this study, additional follow-up data and CTC levels at subsequent follow-up visits were evaluated. EXPERIMENTAL DESIGN: CTCs were enumerated in 177 MBC patients before the initiation of a new course of therapy (baseline) and 3 to 5, 6 to 8, 9 to 14, and 15 to 20 weeks after the initiation of therapy. Progression-free survival (PFS) and overall survival (OS) times were calculated from the dates of each follow-up blood draw. Kaplan-Meier plots and survival analyses were done using a threshold of >/=5 CTCs/7.5 mL at each blood draw. RESULTS: Median PFS times for patients with <5 CTC from each of the five blood draw time points were 7.0, 6.1, 5.6, 7.0, and 6.0 months, respectively. For patients with >/=5 CTC, median PFS from these same time points was significantly shorter: 2.7, 1.3, 1.4, 3.0, and 3.6 months, respectively. Median OS for patients with <5 CTC from the five blood draw time points was all >18.5 months. For patients with >/=5 CTC, median OS from these same time points was significantly shorter: 10.9, 6.3, 6.3, 6.6, and 6.7 months, respectively. Median PFS and OS times at baseline and up to 9 to 14 weeks after the initiation of therapy were statistically significantly different. CONCLUSIONS: Detection of elevated CTCs at any time during therapy is an accurate indication of subsequent rapid disease progression and mortality for MBC patients.
PMID: 16857794 [PubMed - in process]
CTCs can be tested by the CellSearch test available through Quest Diagnostics but is generally only done so far as part of clinical trials I think.
Plus, does anyone REALLY want to KNOW their prognosis is poor. I guess if it was negative one would be more willing to be agressive with treatment.
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