Time-Dependent Prognostic Impact of Circulating Tumor Cells Detection in Non-Metastatic Breast Cancer: 70-Month Analysis of the REMAGUS02 Study

Author:

Bidard François-Clément12,Belin Lisa3,Delaloge Suzette4,Lerebours Florence1,Ngo Charlotte5,Reyal Fabien5,Alran Séverine5,Giacchetti Sylvie6,Marty Michel6,Lebofsky Ronald2,Pierga Jean-Yves127

Affiliation:

1. Department of Medical Oncology, Institut Curie, 26 rue d'Ulm, 75005 Paris, France

2. Laboratory of Circulating Cancer Biomarker, Institut Curie, 26 rue d'Ulm, 75005 Paris, France

3. Department of Biostatistics, Institut Curie, 26 rue d'Ulm, 75005 Paris, France

4. Department of Medicine, Institut Gustave Roussy, 39 rue Desmoulins, 94805 Villejuif, France

5. Department of Surgery, Institut Curie, 26 rue d'Ulm, 75005 Paris, France

6. Department of Medical Oncology, Hôpital Saint Louis, 1 Avenue Vellefaux, 75011 Paris, France

7. Université Paris Descartes, 15 rue de l'École de Médecine, 75006 Paris, France

Abstract

Introduction. In non-metastatic breast cancer patients, the REMAGUS02 neoadjuvant study was the first to report a significant impact of circulating tumor cells (CTCs) detection by the CellSearch system on the distant metastasis-free survival (DMFS) and overall survival (OS) endpoints. However, these results were only reported after a short follow-up. Here, we present the updated data, with a longer follow-up.Material and Methods. CTC count was performed before and after neoadjuvant chemotherapy in 118 patients and correlated to survival.Results. CTC count results were available before and/or after neoadjuvant chemotherapy in 115 patients. After a median follow-up of 70 months, detection of ≥1 CTC/7.5 mL before chemotherapy (N=95) was significantly associated with DMFS (P=0.04) and OS (P=0.03), whereas postchemotherapy CTC detection (N=85) had no significant impact. In multivariable analysis, prechemotherapy CTC and triple negative phenotype were the two independent prognostic factors for survival. We observed that the CTC impact is most significant during the first three years of follow-up.Discussion. We confirm that the detection of CTC is independently associated with a significantly worse outcome, but mainly during the first 3-4 years of follow-up. No prognostic impact is seen in patients who are still relapse-free at this moment.

Publisher

Hindawi Limited

Subject

Cancer Research,Pharmacology (medical),Oncology

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