Presence of Circulating Tumor Cells in High-Risk Early Breast Cancer During Follow-Up and Prognosis

Trapp, Elisabeth; Janni, Wolfgang; Scheffold, Christian; Jückstöck, Julia; Andergassen, Ulrich; Gregorio, Amelie de; Alunni-Fabbroni, Marianna; Tzschaschel, M; Polasik, A; Koch, Julian; Friedl, Thomas W. P.; Fasching, Peter A.; Haeberle, Lothar; Fehm, Tanja; Schneeweiß, Andreas; Beckmann, Matthias W.; Pantel, Klaus; Mueller, Volkmar; Rack, Brigitte; Scholz, Christoph

doi:10.1093/jnci/djy152

Cited by 115 publications

(63 citation statements)

References 29 publications

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“…The CTC-positivity after five years was the strongest predictor of late disease recurrence in patients with HR+ breast cancer that had no signs of disease recurrence, as presented by Sparano et al in multivariate analysis [84]. Similarly, in SUCCESS-A study CTCs detected at 2 years (in 18.2% of patients) were associated with a 3.9-fold increased risk of death and a 2.3-fold higher recurrence risk in multivariable models [86]. Analysis of 206 patients enrolled in the same study with known CTC status at 5 years, revealed that CTCs-positivity was found in 7.8% and was associated with a 6-fold increase in recurrence [85].…”

Section: Early Breast Cancer; Prognostic Value Programs and Trialsmentioning

confidence: 67%

Circulating Tumor Cells in Early and Advanced Breast Cancer; Biology and Prognostic Value

Fabisiewicz

Szostakowska-Rodzoś

Żaczek

et al. 2020

IJMS

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Breast cancer metastasis is the leading cause of cancer deaths in women and is difficult to combat due to the long periods in which disseminated cells retain a potential to be re-activated and start the relapse. Assessing the number and molecular profile of circulating tumor cells (CTCs) in breast cancer patients, especially in early breast cancer, should help in identifying the possibility of relapse in time for therapeutic intervention to prevent or delay recurrence. While metastatic breast cancer is considered incurable, molecular analysis of CTCs still have a potential to define particular susceptibilities of the cells representing the current tumor burden, which may differ considerably from the cells of the primary tumor, and offer more tailored therapy to the patients. In this review we inspect the routes to metastasis and how they can be linked to specific features of CTCs, how CTC analysis may be used in therapy, and what is the current status of the research and efforts to include CTC analysis in clinical practice.There are two main hypotheses describing cancer dissemination: linear progression, according to which, metastatic potential is gained gradually, and the whole process proceeds in steps and needs time, and parallel progression, according to which dissemination takes place early on, even before clinical manifestation of the tumor [6,7] (Figure 1). In the linear progression model, the evolving primary tumor gives rise to metastases due to increasingly aggressive and invasive phenotypes of the subclones of tumor cells. This model is in agreement with the postulated role of the epithelial-to-mesenchymal transition (EMT) in cancer and assumes active degradation of the stroma and migration into blood vessels by the motile, invasive single cells that broke loose from the epithelial monolayer. In contrast to that, parallel progression postulates intravasation by passive shedding, which may take place shortly after the angiogenic switch, occurring during the early, pre-invasive stage of tumor development [8,9].

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Section: Early Breast Cancer; Prognostic Value Programs and Trialsmentioning

confidence: 67%

Circulating Tumor Cells in Early and Advanced Breast Cancer; Biology and Prognostic Value

Fabisiewicz

Szostakowska-Rodzoś

Żaczek

et al. 2020

IJMS

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“…Therefore, physicians will refuse to implement liquid biopsies for CTCs. Only in a few malignancies have studies shown that CTCs can predict whether patients will not benefit from therapies [36,[53][54][55][56][57]. Unfortunately, it is still unknown whether a switch to therapies should be implemented and would lead to a better outcome.…”

Section: Required Steps Before Clinical Implementation Can Be Consideredmentioning

confidence: 99%

Required Evidence for Clinical Applications of Liquid Biopsy Using Especially CTCs in Lung Cancer

Tamminga

Groen

2020

Applied Sciences

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As therapies have become more and more dependent on tumor as well as patient characteristics, obtaining tumor material has become of great importance. Liquid biopsies hold much potential as shown by a large amount of evidence across several studies. Clinical applications for circulating tumor cells (CTCs) are unfortunately still lacking. In part this is due to a lack of studies comparing liquid biopsies to conventional diagnostics and response measurements as well as studies showing that liquid biopsies can be used to switch therapies leading to improved outcomes. However, liquid biopsies using ctDNA for specific markers such as EGFR, ALK, ROS1 or RET have clinical applications because specific drugs are available.

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“…Several studies have highlighted the correlation between CTC burden and treatment effect, indicating the prognostic value for patients receiving chemotherapy or surgery and the potential of surveillance of disease recurrence or metastasis [ Table 1]. Several years after chemotherapy, patients with high-risk breast cancer with elevated CTC counts in their peripheral blood were reported to have worst survival prospect [77] . Similarly, patients with colorectal cancer with elevated CTC counts were more likely to have recurrence after 3 years of curative resection, showing the relation between post-operative CTCs and poor prognosis [78] .…”

Section: Prognostic and Diagnostic Value Of Ctcsmentioning

confidence: 99%

Sensitive and specific detection of circulating tumor cells promotes precision medicine for cancer

Huang¹,

Chen²,

Jiang³

et al. 2019

JCMT

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Circulating tumor cells (CTCs) have the potential to provide genetic information for heterogeneous tumors, which may be useful for monitoring disease progression and developing personalized therapies. However, the isolation of CTCs for molecular analysis is challenging due to their extreme rarity and phenotypic heterogeneity, which hinders the transformation of CTCs into traditional clinical applications. In order to achieve clinically significant CTC detection, devices utilizing novel microfluidics and nanotechnology have been developed to achieve high sensitivity and specificity capture of CTCs. In this review, we discuss these newly developed devices for CTC capture and molecular characterization for early diagnosis and determining ideal treatment regimen to better manage these cancers clinically. In addition, the potential prognostic values of CTCs as treatment guidelines and that ultimately contribute to realize personalized treatment are also discussed.

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Presence of Circulating Tumor Cells in High-Risk Early Breast Cancer During Follow-Up and Prognosis

Cited by 115 publications

References 29 publications

Circulating Tumor Cells in Early and Advanced Breast Cancer; Biology and Prognostic Value

Circulating Tumor Cells in Early and Advanced Breast Cancer; Biology and Prognostic Value

Required Evidence for Clinical Applications of Liquid Biopsy Using Especially CTCs in Lung Cancer

Sensitive and specific detection of circulating tumor cells promotes precision medicine for cancer

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