Circulating tumor cells, disease progression, and survival in metastatic breast cancer

Massimo Cristofanilli ¹, G Thomas Budd , Matthew J Ellis

⁰Department of Breast Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA. mcristof@mdanderson.org

The New England Journal of Medicine +

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August 20, 2004

View abstract on PubMed

Summary

High levels of circulating tumor cells (CTCs) in metastatic breast cancer patients predict shorter survival. Monitoring CTCs before and during treatment offers valuable prognostic information for patient outcomes.

Area Of Science

Oncology
Medical Diagnostics
Biomarkers

Background

Metastatic breast cancer (MBC) poses significant survival challenges.
Identifying reliable prognostic markers is crucial for patient management.

Purpose Of The Study

To investigate the predictive value of circulating tumor cell (CTC) levels for survival in patients with MBC.
To determine if CTC counts before and during treatment correlate with progression-free and overall survival.

Main Methods

A prospective, multicenter study involving 177 MBC patients.
CTC levels were measured at baseline before new treatment and at the first follow-up visit.
Disease progression and treatment response were assessed using standard imaging.

Main Results

Elevated baseline CTC levels (≥5 cells/7.5ml) were associated with significantly shorter progression-free survival (2.7 vs. 7.0 months) and overall survival (10.1 vs. >18 months).
These survival differences persisted at the first follow-up visit (PFS: 2.1 vs. 7.0 months; OS: 8.2 vs. >18 months).
Multivariate analysis identified baseline and follow-up CTC levels as the strongest independent predictors of survival.

Conclusions

Circulating tumor cell count before treatment is an independent predictor of progression-free and overall survival in metastatic breast cancer.
CTC monitoring provides critical prognostic information for MBC patients.

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