Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Trapp, E; Janni, W; Schindlbeck, C; Jückstock, J; Andergassen, U; de Gregorio, A; Alunni-Fabbroni, M; Tzschaschel, M; Polasik, A; Koch, JG; Friedl, TWP; Fasching, PA; Haeberle, L; Fehm, T; Schneeweiss, A; Beckmann, MW; Pantel, K; Mueller, V; Rack, B; Scholz, C; SUCCESS Study Group.
Presence of Circulating Tumor Cells in High-Risk Early Breast Cancer During Follow-Up and Prognosis.
J Natl Cancer Inst. 2019; 111(4):380-387
Doi: 10.1093/jnci/djy152
Web of Science
PubMed
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- Leading authors Med Uni Graz
- Trapp Elisabeth Katharina
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- Abstract:
- The prognostic relevance of circulating tumor cells (CTCs) at the time of primary diagnosis has been well established. However, little information is available regarding their prognostic relevance to follow-up care. The multicenter, open-label, phase III SUCCESS A trial compared two adjuvant chemotherapy regimens followed by 2 vs 5 years of zoledronate for early-stage, high-risk breast cancer patients. The presence of CTCs was assessed before and 2 years after chemotherapy using the FDA-approved CellSearch System. Overall survival (OS) and disease-free survival (DFS) were analyzed using univariate log-rank tests and multivariable Cox regressions. OS and DFS were measured starting from an assessment of CTCs 2 years after the completion of chemotherapy. All statistical tests were two-sided. The sample included 1087 patients who participated in the translational research program of the SUCCESS A trial and for whom sufficient translational data were available regarding CTC status at baseline and at the 2-year follow-up visit. Two years after chemotherapy, 198 (18.2%) patients were CTC-positive. The median follow-up after this timepoint was 37 months. Cox regressions that included CTC status at baseline revealed that CTC status 2 years after chemotherapy had statistically significant and independent prognostic relevance for OS (hazard ratio [HR] = 3.91, 95% confidence interval [CI] = 2.04 to 7.52, P < .001) and DFS (HR = 2.31, 95% CI = 1.50 to 3.55, P < .001). The presence of CTCs 2 years after chemotherapy was associated with decreased OS and DFS. Based on these results, active individualized surveillance strategies for breast cancer survivors based on biomarkers should be reconsidered. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.