CTCs could predict chance of survival
7 May 2012 by Evoluted New Media
Circulating tumour cells (CTCs) in the blood of women with early breast cancer could provide important information about their chances of surviving the disease say German researchers.
Results from the first large-scale study of the relevance of CTCs in early breast cancer show patients with at least five CTCs detected straight after surgery have a four-fold increase in the risk of recurrence and a three-fold increase in risk of death. Researchers suggest CTCs might be a more accurate evaluation of disease outcome and a target for treatment.
Researchers from nine German university hospitals analysed the number of CTCs in the blood of 2026 patients in a trial called SUCCESS A. The patients had a complete resection of their primary tumour prior to commencing chemotherapy and CTCs were detected in 21.5% of them, a lower rate than usually seen in metastatic breast cancer.
The number of CTCs in blood is very small but recent advances in technology mean it is possible to find CTCs using a semi-automated detection device, offer an alternative to bone marrow samples.
“Looking for CTCs in blood samples is much less invasive than taking bone marrow,” said Dr Bernadette Jäger. “Although there is no direct advantage to the patient knowing her CTC status, this is already a step forward, and in the future we believe that the presence of CTCs could be used as a marker for monitoring the efficacy of treatment.”
The method can be combined with routine blood collection and carried out frequently during the course of the disease. Researchers are already following up their work by evaluating CTC counts of patients straight after chemotherapy and at two and five year intervals.
Researchers will also test the effect of adding a secondary drug called lapatinib to standard treatment in patients with HER2-negative metastatic breast cancer and HER2-positive CTCs. HER2 overexpression is known to play an important role in the progression of certain aggressive types of breast cancer.
“HER2 status can change as the disease advances,” said Jäger. “If there is no relapsed tumour in the primary cancer site it is difficult to perform a new histopathological examination. Being able to detect this change in CTCs would be much less invasive than having to take a biopsy of a metastasis which is often anatomically inaccessible.”
If the therapy is successful, researchers can be sure they are attacking the cancer in the right way and in the right place.
