How do you know if Herceptin is working??

[Lani]

One of many--just put DTC or disseminated tumor cells and prognostic and breast cancer into Entrez PUBMED

THis one just came out and is the largest study ever with long followup


Ann Surg Oncol. 2012 Dec 21. [Epub ahead of print]
Prognostic Value of Disseminated Tumor Cells in the Bone Marrow of Patients with Operable Primary Breast Cancer: A Long-term Follow-up Study.
Domschke C, Diel IJ, Englert S, Kalteisen S, Mayer L, Rom J, Heil J, Sohn C, Schuetz F.
Source
Breast Unit, University of Heidelberg, Heidelberg, Germany.
Abstract
BACKGROUND:
Detection of disseminated tumor cells (DTC) in primary breast cancer (BC) patients' bone marrow (BM) seems to be a surrogate marker of tumor spread and an independent prognostic factor for disease-free and overall survival.
METHODS:
Here we present the largest single-center cohort of patients (n = 1378) with the longest observation time (median 82.0 months). Immunocytochemical staining was performed using murine monoclonal antibody 2E11 with the avidin-biotin complex technique.
RESULTS:
At primary surgery, 49 % of patients showed MUC-1 positive cells inside their BM. Patients without BM DTC had significantly more often T1-tumors (P = 0.007) with less often affected axillary lymph nodes (P < 0.001). We observed a significantly higher incidence of distant metastases in DTC positive patients (P < 0.001). This leads to a reduced disease-free survival (P < 0.0001). Furthermore, in DTC positive patients there was a higher mortality rate and, accordingly, a reduced overall survival (P < 0.0001).
CONCLUSIONS:
Due to the presence of BM DTC, patients with a clinically poorer outcome can be identified at primary surgery. We therefore suggest that DTC analysis can be used as a prognostic factor and monitoring tool in clinical trials. Future study concepts relating to DTC should aim at identification of BC patients who may profit from adjuvant systemic therapy.
PMID: 23263703 [PubMed - as supplied by publisher]
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