Circulating tumor cells versus imaging - Predicting overall survival in metastatic breast cancer

G. Thomas Budd, Massimo Cristofanilli, Mathew J. Ellis, Alison T Stopeck, Ernest Borden, M. Craig Miller, Jeri Matera, Madeline Repollet, Gerald V. Doyle, Leon W M M Terstappen, Daniel F. Hayes

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Abstract

Purpose: The presence of ≥5 circulating tumor cells (CTC) in 7.5 mL blood from patients with measurable metastatic breast cancer before and/or after initiation of therapy is associated with shorter progression-free and overall survival. In this report, we compared the use of CTCs to radiology for prediction of overall survival. Experimental Design: One hundred thirty-eight metastatic breast cancer patients had imaging studies done before and a median of 10 weeks after the initiation of therapy. All scans were centrally reviewed by two independent radiologists using WHO criteria to determine radiologic response. CTC counts were determined ∼4 weeks after initiation of therapy. Specimens were analyzed at one of seven laboratories and reviewed by a central laboratory. Results: Interreader variability for radiologic responses and CTC counts were 15.2% and 0.7%, respectively. The median overall survival of 13 (9%) patients with radiologic nonprogression and ≥5 CTCs was significantly shorter than that of the 83 (60%) patients with radiologic non-progression and <5 CTCs (15.3 versus 26.9 months; P = 0.0389). The median overall survival of the 20 (14%) patients with radiologic progression and <5 CTCs was significantly longer than the 22 (16%) patients with ≥5 CTCs that showed progression by radiology (19.9 versus 6.4 months; P = 0.0039). Conclusions: Assessment of CTCs is an earlier, more reproducible indication of disease status than current imaging methods. CTCs may be a superior surrogate end point, as they are highly reproducible and correlate better with overall survival than do changes determined by traditional radiology.

Original languageEnglish (US)
Pages (from-to)6403-6409
Number of pages7
JournalClinical Cancer Research
Volume12
Issue number21
DOIs
StatePublished - Nov 1 2006

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Circulating Neoplastic Cells
Breast Neoplasms
Survival
Radiology
Cell Count
Disease-Free Survival
Research Design
Therapeutics
Biomarkers

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Budd, G. T., Cristofanilli, M., Ellis, M. J., Stopeck, A. T., Borden, E., Miller, M. C., ... Hayes, D. F. (2006). Circulating tumor cells versus imaging - Predicting overall survival in metastatic breast cancer. Clinical Cancer Research, 12(21), 6403-6409. https://doi.org/10.1158/1078-0432.CCR-05-1769

Circulating tumor cells versus imaging - Predicting overall survival in metastatic breast cancer. / Budd, G. Thomas; Cristofanilli, Massimo; Ellis, Mathew J.; Stopeck, Alison T; Borden, Ernest; Miller, M. Craig; Matera, Jeri; Repollet, Madeline; Doyle, Gerald V.; Terstappen, Leon W M M; Hayes, Daniel F.

In: Clinical Cancer Research, Vol. 12, No. 21, 01.11.2006, p. 6403-6409.

Research output: Contribution to journalArticle

Budd, GT, Cristofanilli, M, Ellis, MJ, Stopeck, AT, Borden, E, Miller, MC, Matera, J, Repollet, M, Doyle, GV, Terstappen, LWMM & Hayes, DF 2006, 'Circulating tumor cells versus imaging - Predicting overall survival in metastatic breast cancer', Clinical Cancer Research, vol. 12, no. 21, pp. 6403-6409. https://doi.org/10.1158/1078-0432.CCR-05-1769
Budd, G. Thomas ; Cristofanilli, Massimo ; Ellis, Mathew J. ; Stopeck, Alison T ; Borden, Ernest ; Miller, M. Craig ; Matera, Jeri ; Repollet, Madeline ; Doyle, Gerald V. ; Terstappen, Leon W M M ; Hayes, Daniel F. / Circulating tumor cells versus imaging - Predicting overall survival in metastatic breast cancer. In: Clinical Cancer Research. 2006 ; Vol. 12, No. 21. pp. 6403-6409.
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abstract = "Purpose: The presence of ≥5 circulating tumor cells (CTC) in 7.5 mL blood from patients with measurable metastatic breast cancer before and/or after initiation of therapy is associated with shorter progression-free and overall survival. In this report, we compared the use of CTCs to radiology for prediction of overall survival. Experimental Design: One hundred thirty-eight metastatic breast cancer patients had imaging studies done before and a median of 10 weeks after the initiation of therapy. All scans were centrally reviewed by two independent radiologists using WHO criteria to determine radiologic response. CTC counts were determined ∼4 weeks after initiation of therapy. Specimens were analyzed at one of seven laboratories and reviewed by a central laboratory. Results: Interreader variability for radiologic responses and CTC counts were 15.2{\%} and 0.7{\%}, respectively. The median overall survival of 13 (9{\%}) patients with radiologic nonprogression and ≥5 CTCs was significantly shorter than that of the 83 (60{\%}) patients with radiologic non-progression and <5 CTCs (15.3 versus 26.9 months; P = 0.0389). The median overall survival of the 20 (14{\%}) patients with radiologic progression and <5 CTCs was significantly longer than the 22 (16{\%}) patients with ≥5 CTCs that showed progression by radiology (19.9 versus 6.4 months; P = 0.0039). Conclusions: Assessment of CTCs is an earlier, more reproducible indication of disease status than current imaging methods. CTCs may be a superior surrogate end point, as they are highly reproducible and correlate better with overall survival than do changes determined by traditional radiology.",
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AU - Cristofanilli, Massimo

AU - Ellis, Mathew J.

AU - Stopeck, Alison T

AU - Borden, Ernest

AU - Miller, M. Craig

AU - Matera, Jeri

AU - Repollet, Madeline

AU - Doyle, Gerald V.

AU - Terstappen, Leon W M M

AU - Hayes, Daniel F.

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N2 - Purpose: The presence of ≥5 circulating tumor cells (CTC) in 7.5 mL blood from patients with measurable metastatic breast cancer before and/or after initiation of therapy is associated with shorter progression-free and overall survival. In this report, we compared the use of CTCs to radiology for prediction of overall survival. Experimental Design: One hundred thirty-eight metastatic breast cancer patients had imaging studies done before and a median of 10 weeks after the initiation of therapy. All scans were centrally reviewed by two independent radiologists using WHO criteria to determine radiologic response. CTC counts were determined ∼4 weeks after initiation of therapy. Specimens were analyzed at one of seven laboratories and reviewed by a central laboratory. Results: Interreader variability for radiologic responses and CTC counts were 15.2% and 0.7%, respectively. The median overall survival of 13 (9%) patients with radiologic nonprogression and ≥5 CTCs was significantly shorter than that of the 83 (60%) patients with radiologic non-progression and <5 CTCs (15.3 versus 26.9 months; P = 0.0389). The median overall survival of the 20 (14%) patients with radiologic progression and <5 CTCs was significantly longer than the 22 (16%) patients with ≥5 CTCs that showed progression by radiology (19.9 versus 6.4 months; P = 0.0039). Conclusions: Assessment of CTCs is an earlier, more reproducible indication of disease status than current imaging methods. CTCs may be a superior surrogate end point, as they are highly reproducible and correlate better with overall survival than do changes determined by traditional radiology.

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