Trapp E, Janni W, Schindlbeck C, Jückstock J, Andergassen U, De Gregorio A, Alunni-Fabbroni M, Tzschaschel M, Polasik A, Koch JG, Friedl TW, Fasching P, Häberle L, Fehm T, Schneeweiss A, Beckmann M, Pantel K, Mueller V, Rack B, Scholz C (2019)
Publication Type: Journal article
Publication year: 2019
Book Volume: 111
Pages Range: 380-387
Journal Issue: 4
DOI: 10.1093/jnci/djy152
Background: 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. Methods: 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. Results: 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] ¼ 3.91, 95% confidence interval [CI] ¼ 2.04 to 7.52, P < .001) and DFS (HR ¼ 2.31, 95% CI ¼ 1.50 to 3.55, P < .001). Conclusion: 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.
APA:
Trapp, E., Janni, W., Schindlbeck, C., Jückstock, J., Andergassen, U., De Gregorio, A.,... Scholz, C. (2019). Presence of circulating tumor cells in high-risk early breast cancer during follow-up and prognosis. Journal of the National Cancer Institute, 111(4), 380-387. https://doi.org/10.1093/jnci/djy152
MLA:
Trapp, Elisabeth, et al. "Presence of circulating tumor cells in high-risk early breast cancer during follow-up and prognosis." Journal of the National Cancer Institute 111.4 (2019): 380-387.
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