Despite significant improvements in screening, early diagnosis, and adjuvant treatment of breast cancer, some women still develop metastatic disease.1 Metastatic breast cancer (MBC) remains an incurable condition, and its treatment is considered palliative; nevertheless, the selection of appropriate treatments is generally associated with survival prolongation.2,3 Moreover, our increasing knowledge of the biology of the disease and the availability of targeted therapies have improved significantly the prognosis of some subsets of patients, such as women with amplification of the erbb2 oncogene.4The use of novel technologies to accurately assess disease status can theoretically provide the possibility of better prognostic stratification for patients with MBC, which should also contribute to better treatment outcomes in this condition. However, measurement of serum tumour marker levels and extensive radiological monitoring of women with a history of primary breast cancer have failed to detect early recurrences and have not provided any survival benefit when tested in large prospective studies.5,6The detection of circulating tumour cells (CTCs) in MBC has been shown to be reliable, sensitive, reproducible, and predictive of prognosis and early treatment response.7 A multicenter prospective trial demonstrated that the level of CTCs in patients with MBC who have measurable disease is a powerful predictor of progression-free and overall survival. In that trial patients with > 5 CTCs per 7.5 ml of blood (a prospectively identified cut-off level) had significantly shorter progression-free and overall survival durations compared to those with < 5 CTCs per 7.5 ml of blood. The continue monitoring of CTCs predicted for disease outcome as early as 3 weeks, therefore indicating the benefit of treatments. Furthermore, in a multivariate analysis, the level of CTCs had a predictive value independent of the line and type of therapy, time to metastasis, site of recurrence (visceral vs. nonvisceral), and hormone receptor status
Clinical utility of measuring circulating tumor cells in metastatic breast cancer / GUARNERI, Valentina; CRISTOFANILLI, M.. - In: CLINICAL BREAST CANCER. - ISSN 1526-8209. - STAMPA. - 7:1(2006), pp. 85-86. [10.3816/CBC.2006.n.018]
Clinical utility of measuring circulating tumor cells in metastatic breast cancer
GUARNERI, Valentina;
2006
Abstract
Despite significant improvements in screening, early diagnosis, and adjuvant treatment of breast cancer, some women still develop metastatic disease.1 Metastatic breast cancer (MBC) remains an incurable condition, and its treatment is considered palliative; nevertheless, the selection of appropriate treatments is generally associated with survival prolongation.2,3 Moreover, our increasing knowledge of the biology of the disease and the availability of targeted therapies have improved significantly the prognosis of some subsets of patients, such as women with amplification of the erbb2 oncogene.4The use of novel technologies to accurately assess disease status can theoretically provide the possibility of better prognostic stratification for patients with MBC, which should also contribute to better treatment outcomes in this condition. However, measurement of serum tumour marker levels and extensive radiological monitoring of women with a history of primary breast cancer have failed to detect early recurrences and have not provided any survival benefit when tested in large prospective studies.5,6The detection of circulating tumour cells (CTCs) in MBC has been shown to be reliable, sensitive, reproducible, and predictive of prognosis and early treatment response.7 A multicenter prospective trial demonstrated that the level of CTCs in patients with MBC who have measurable disease is a powerful predictor of progression-free and overall survival. In that trial patients with > 5 CTCs per 7.5 ml of blood (a prospectively identified cut-off level) had significantly shorter progression-free and overall survival durations compared to those with < 5 CTCs per 7.5 ml of blood. The continue monitoring of CTCs predicted for disease outcome as early as 3 weeks, therefore indicating the benefit of treatments. Furthermore, in a multivariate analysis, the level of CTCs had a predictive value independent of the line and type of therapy, time to metastasis, site of recurrence (visceral vs. nonvisceral), and hormone receptor status
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