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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2016

01-02-2016 | Clinical trial

Detection of disseminated tumor cells from the bone marrow of patients with early breast cancer is associated with high 21-gene recurrence score

Authors: Andreas D. Hartkopf, Markus Wallwiener, Stefan Kommoss, Florin-Andrei Taran, Sara Y. Brucker

Published in: Breast Cancer Research and Treatment | Issue 1/2016

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Abstract

High 21-gene recurrence score (RS) is associated with an impaired prognosis in patients with HR-positive/HER2-negative early breast cancer (EBC) and predictive of response to adjuvant chemotherapy. Detection of disseminated tumor cells (DTCs) in the bone marrow is a surrogate of minimal residual disease and of prognostic value. The aim of this study was to compare DTC detection with the 21-gene RS. DTCs were identified in bone marrow aspirates of HR-positive/HER2-negative EBC patients by immunocytochemistry (pancytokeratin antibody A45-B/B3) and cytomorphology at primary surgery. The 21-gene RS was assessed in paraffin-embedded tumor tissue samples using Oncotype DX (Genomic Health). A total of 114 patients were included in this study. DTCs were detected in 13 of these (11 %). Of the women with a low RS (<18), 5/75 (7 %) were DTC positive. Of the women with an intermediate/high RS (≥18), 8/39 (21 %) were DTC positive (p = 0.03, Chi-squared test). The median RS in DTC-negative patients was significantly lower as compared to DTC-positive patients (15 vs. 20, p = 0.04, Mann–Whitney U test). In conclusion, detection of DTCs in patients with EBC is associated with high 21-gene recurrence score. These findings are meaningful for further basic research that aims to investigate the biological mechanism of tumor cell spread and cancer progression and may have prognostic and/or predictive clinical implications that should be evaluated in future clinical trials.
Literature
1.
Sotiriou C, Pusztai L (2009) Gene-expression signatures in breast cancer. N Engl J Med 360(8):790–800CrossRefPubMed
2.
Gyorffy B, Hatzis C, Sanft T, Hofstatter E, Aktas B, Pusztai L (2015) Multigene prognostic tests in breast cancer: past, present, future. Breast Cancer Res 17:11CrossRefPubMedPubMedCentral
3.
Paik S, Shak S, Tang G, Kim C, Baker J, Cronin M, Baehner FL, Walker MG, Watson D, Park T, Hiller W, Fisher ER, Wickerham DL, Bryant J, Wolmark N (2004) A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med 351(27):2817–2826CrossRefPubMed
4.
Paik S, Tang G, Shak S, Kim C, Baker J, Kim W, Cronin M, Baehner FL, Watson D, Bryant J, Costantino JP, Geyer CE Jr, Wickerham DL, Wolmark N (2006) Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol 24(23):3726–3734CrossRefPubMed
5.
Albain KS, Barlow WE, Shak S, Hortobagyi GN, Livingston RB, Yeh IT, Ravdin P, Bugarini R, Baehner FL, Davidson NE, Sledge GW, Winer EP, Hudis C, Ingle JN, Perez EA, Pritchard KI, Shepherd L, Gralow JR, Yoshizawa C, Allred DC, Osborne CK, Hayes DF, Breast Cancer Inter Group of North America (2010) Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised trial. Lancet Oncol 11(1):55–65CrossRefPubMedPubMedCentral
6.
Braun S, Vogl FD, Naume B, Janni W, Osborne MP, Coombes RC, Schlimok G, Diel IJ, Gerber B, Gebauer G, Pierga JY, Marth C, Oruzio D, Wiedswang G, Solomayer EF, Kundt G, Strobl B, Fehm T, Wong GY, Bliss J, Vincent-Salomon A, Pantel K (2005) A pooled analysis of bone marrow micrometastasis in breast cancer. N Engl J Med 353(8):793–802CrossRefPubMed
7.
Hartkopf AD, Taran FA, Wallwiener M, Hahn M, Becker S, Solomayer EF, Brucker SY, Fehm TN, Wallwiener D (2014) Prognostic relevance of disseminated tumour cells from the bone marrow of early stage breast cancer patients—results from a large single-centre analysis. Eur J Cancer 50(15):2550–2559CrossRefPubMed
8.
Hartkopf AD, Taran FA, Brucker S, Hahn M, Wallwiener D, Becker S, Solomayer EF, Wallwiener M, Fehm T (2013) The prognostic relevance of disseminated tumor cells (DTC) form the bone marrow (BM) in different molecular subtypes of primary breast cancer (PBC) patients. In: San Antonio breast cancer symposium abstract PD6-7
9.
Stefanovic S, Diel I, Sinn P, Englert S, Hennigs A, Mayer C, Schott S, Wallwiener M, Blumenstein M, Golatta M, Heil J, Rom J, Sohn C, Schneeweiss A, Schuetz F, Domschke C (2016) Disseminated tumor cells in the bone marrow of patients with operable primary breast cancer: prognostic impact in immunophenotypic subgroups and clinical implication for bisphosphonate treatment. Ann Surg Oncol 23(3):757–766
10.
Bauer KD, de la Torre-Bueno J, Diel IJ, Hawes D, Decker WJ, Priddy C, Bossy B, Ludmann S, Yamamoto K, Masih AS, Espinoza FP, Harrington DS (2000) Reliable and sensitive analysis of occult bone marrow metastases using automated cellular imaging. Clin Cancer Res 6(9):3552–3559PubMed
11.
Borgen E, Naume B, Nesland JM, Kvalheim G, Beiske K, Fodstad O, Diel I, Solomayer EF, Theocharous P, Coombes RC, Smith BM, Wunder E, Marolleau JP, Garcia J, Pantel K (1999) Standardization of the immunocytochemical detection of cancer cells in BM and blood: I. establishment of objective criteria for the evaluation of immunostained cells. Cytotherapy 1(5):377–388CrossRefPubMed
12.
Fehm T, Braun S, Muller V, Janni W, Gebauer G, Marth C, Schindlbeck C, Wallwiener D, Borgen E, Naume B, Pantel K, Solomayer E (2006) A concept for the standardized detection of disseminated tumor cells in bone marrow from patients with primary breast cancer and its clinical implementation. Cancer 107(5):885–892CrossRefPubMed
13.
Aktas B, Bankfalvi A, Heubner M, Kimmig R, Kasimir-Bauer S (2013) Evaluation and correlation of risk recurrence in early breast cancer assessed by Oncotype DX, clinicopathological markers and tumor cell dissemination in the blood and bone marrow. Mol Clin Oncol 1(6):1049–1054PubMedPubMedCentral
14.
Domschke C, Diel IJ, Englert S, Kalteisen S, Mayer L, Rom J, Heil J, Sohn C, Schuetz F (2013) Prognostic value of disseminated tumor cells in the bone marrow of patients with operable primary breast cancer: a long-term follow-up study. Ann Surg Oncol 20(6):1865–1871CrossRefPubMed
15.
Hartkopf AD, Taran FA, Wallwiener M, Hagenbeck C, Melcher C, Krawczyk N, Hahn M, Wallwiener D, Fehm T (2013) The presence and prognostic impact of apoptotic and nonapoptotic disseminated tumor cells in the bone marrow of primary breast cancer patients after neoadjuvant chemotherapy. Breast Cancer Res 15(5):R94CrossRefPubMedPubMedCentral
16.
Klein CA (2009) Parallel progression of primary tumours and metastases. Nat Rev Cancer 9(4):302–312CrossRefPubMed
17.
Narod SA, Iqbal J, Giannakeas V, Sopik V, Sun P (2015) Breast cancer mortality after a diagnosis of ductal carcinoma in situ. JAMA Oncol 1(7):888–896CrossRefPubMed
18.
Banys M, Hahn M, Gruber I, Krawczyk N, Wallwiener M, Hartkopf A, Taran FA, Rohm C, Kurth R, Becker S, Solomayer EF, Wallwiener D, Staebler A, Fehm T (2014) Detection and clinical relevance of hematogenous tumor cell dissemination in patients with ductal carcinoma in situ. Breast Cancer Res Treat 144(3):531–538CrossRefPubMed
Metadata
Title
Detection of disseminated tumor cells from the bone marrow of patients with early breast cancer is associated with high 21-gene recurrence score
Authors
Andreas D. Hartkopf
Markus Wallwiener
Stefan Kommoss
Florin-Andrei Taran
Sara Y. Brucker
Publication date
01-02-2016
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2016
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-016-3728-9

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