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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2020

Open Access 01-07-2020 | Breast Cancer | Clinical trial

HER2-targeted therapy influences CTC status in metastatic breast cancer

Authors: Thomas M. Deutsch, Sabine Riethdorf, Carlo Fremd, Manuel Feisst, Juliane Nees, Chiara Fischer, Andreas D. Hartkopf, Klaus Pantel, Andreas Trumpp, Florian Schütz, Andreas Schneeweiss, Markus Wallwiener

Published in: Breast Cancer Research and Treatment | Issue 1/2020

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Abstract

Purpose

As an independent, negative-prognostic biomarker for progression-free survival (PFS) and overall survival (OS), circulating tumor cells (CTCs) constitute a promising component for developing a liquid biopsy for patients with metastatic breast cancer (MBC). The effects of HER2-targeted therapy such as trastuzumab, pertuzumab, T-DM1, and lapatinib on CTC status and longitudinal enumeration were assessed in this trial.

Methods

CTC status of 264 patients with MBC was analyzed prior to and after 4 weeks of a new line of palliative systemic therapy. CTCs were assessed using CellSearch®. Three groups were compared: patients with HER2-positive MBC receiving ongoing HER2-targeted therapy (n = 28), patients with de novo HER2-positive MBC and no HER2-targeted therapy in the last 12 months prior to enrollment and start of HER2-targeted therapy (n = 15), and patients with HER2-nonamplified disease and no HER2-targeted therapy (n = 212).

Results

Positive CTC status (≥ 5 CTC/7.5 ml blood) at enrollment was observed in the 3 groups for 17.9, 46.7, and 46.2% (p = 0.02) of patients, respectively. At least one CTC/7.5 ml was seen in 28.6, 53.3, and 67.0% (p < 0.001) of these patients. Furthermore, 3.6, 40.0, and 3.3% (p < 0.001) of the patients had at least one HER2-positive CTC. After 4 weeks of therapy 7.1, 0.0, and 31.1% (p = 0.001) of patients had still a positive CTC status (≥ 5 CTC/7.5 ml blood). At least one CTC/7.5 ml was still observed in 25.0, 20.0, and 50.5% (p = 0.004) of the patients. Furthermore, 7.1, 0.0, and 1.9% (p = 0.187) had at least one HER2-positive CTC. After 3 months of therapy, 35.7, 20.0, and 28.3% (p = 0.536) showed disease progression.

Conclusions

HER2-targeted therapy seems to reduce the overall CTC count in patients with MBC. This should be taken into account when CTC status is used as an indicator for aggressive or indolent metastatic tumor disease.
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Metadata
Title
HER2-targeted therapy influences CTC status in metastatic breast cancer
Authors
Thomas M. Deutsch
Sabine Riethdorf
Carlo Fremd
Manuel Feisst
Juliane Nees
Chiara Fischer
Andreas D. Hartkopf
Klaus Pantel
Andreas Trumpp
Florian Schütz
Andreas Schneeweiss
Markus Wallwiener
Publication date
01-07-2020
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-020-05687-2

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