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01-09-2014 | Clinical trial

Tumor cell dissemination to the bone marrow and blood is associated with poor outcome in patients with metastatic breast cancer

Authors: Andreas D. Hartkopf, Diana Stefanescu, Markus Wallwiener, Markus Hahn, Sven Becker, Erich-Franz Solomayer, Tanja N. Fehm, Sara Y. Brucker, Florin-Andrei Taran

Published in: Breast Cancer Research and Treatment | Issue 2/2014

Abstract

The purpose of this study was to assess the impact of disseminated tumor cells (DTCs) on progression-free and overall survival (OS) in patients with metastatic breast cancer (MBC) and to compare it to simultaneous detection of circulating tumor cells (CTCs) from the blood in a subgroup. Disseminated tumor cells were identified in bone marrow (BM) aspirates by immunocytochemistry (pancytokeratin antibody A45-B/B3) and cytomorphology prior to the beginning of a new-line therapy. CTCs were enumerated by the CellSearch^® technology. BM was obtained from 178 patients with MBC; 64/178 (36 %) patients were DTC-positive. Disseminated tumor cells occurred more frequently in patients with visceral metastases (p = 0.020) and ≥2 lines of therapy (p = 0.017). CTCs were assessed in 33 of these patients and 17/33 (52 %) patients had CTC counts ≥5 CTCs/7.5 ml blood. There was no significant association between the DTC and CTC status. Univariate analysis revealed DTC detection as a significant predictor of poor OS (p < 0.001); median OS in DTC-negative versus DTC-positive patients was 52 [95 % confidence interval (CI) 38–67] versus 28 [95 % CI 19–37] months. Moreover, as described previously, patients with ≥5 CTCs/7.5 ml blood were at an increased risk of disease progression (p = 0.026) and death (p = 0.025). Disseminated tumor cells are predictors of poor prognosis in MBC, highlighting the role of tumor cell dissemination into the BM for breast cancer progression. The absence of a significant association between concurrent DTCs and CTCs suggests they might represent different aspects of systemic BC spread.

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Title: Tumor cell dissemination to the bone marrow and blood is associated with poor outcome in patients with metastatic breast cancer
Authors: Andreas D. Hartkopf
Diana Stefanescu
Markus Wallwiener
Markus Hahn
Sven Becker
Erich-Franz Solomayer
Tanja N. Fehm
Sara Y. Brucker
Florin-Andrei Taran
Publication date: 01-09-2014
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 2/2014
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-014-3113-5

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