This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pierga, J.-Y. Articles by Marty, M. Search for Related Content PubMed PubMed Citation Articles by Pierga, J.-Y. Articles by Marty, M.

Circulating Tumor Cell Detection Predicts Early Metastatic Relapse After Neoadjuvant Chemotherapy in Large Operable and Locally Advanced Breast Cancer in a Phase II Randomized Trial

Authors' Affiliations: ¹ Institut Curie, Paris, ² University Paris Descartes, ³ Centre René Huguenin, Saint-Cloud, ⁴ Institut Gustave Roussy, Villejuif, ⁵ Hôpital Saint-Louis, Paris, France

Requests for reprints: Jean-Yves Pierga, Institut Curie, 26 rue d'Ulm, 75005 Paris, France. Phone: 33-1-44-32-46-81; Fax: 33-1-44-32-46-71; E-mail: jean-yves.pierga{at}curie.net.

Purpose: Circulating tumor cells in blood from metastatic breast cancer patients have been reported as a surrogate marker for tumor response and shorter survival. The aim of this study was to determine whether circulating tumor cells are present in the blood of patients with large operable or locally advanced breast cancer before neoadjuvant chemotherapy and after neoadjuvant chemotherapy before surgery.

Experimental Design: Blood samples of 7.5 mL were obtained on CellSave tubes from patients included in a phase II trial (REMAGUS 02). Circulating tumor cells were immunomagnetically separated and fluorescently stained by the CellSearch system. Blood from 20 metastatic breast cancer patients was used as a positive control.

Results: From October 2004 to July 2006, preneoadjuvant chemotherapy and/or postneoadjuvant chemotherapy blood samples were obtained from 118 patients. At least 1 circulating tumor cell was detected in 22 of 97 patients with preneoadjuvant chemotherapy samples (23%; 95% confidence interval, 15-31%; median, 2 cells; range, 1-17 cells). Circulating tumor cell positivity rates were 17% in 86 postneoadjuvant chemotherapy samples and 27% in all 118 patients. Persistence of circulating tumor cells at the end of neoadjuvant chemotherapy was not correlated with treatment response. After a short median follow-up of 18 months, the presence of circulating tumor cells (P = 0.017), hormone receptor negativity, and large tumor size were independent prognostic factors for shorter distant metastasis–free survival.

Conclusion: Circulating tumor cells can be detected by the CellSearch system at a low cutoff of 1 cell in 27% of patients receiving neoadjuvant chemotherapy. Circulating tumor cell detection was not correlated to the primary tumor response but is an independent prognostic factor for early relapse.

This article has been cited by other articles:

				C. Massard, A. Chauchereau, and K. Fizazi The quest for the 'bony Grail' of detecting circulating tumour cells in patients with prostate cancer Ann. Onc., February 1, 2009; 20(2): 197 - 199. [Full Text] [PDF]