Mesenchymal characterization: alternative to simple CTC detection in two clinical trials

Area of Science:

• Oncology
• Molecular Biology
• Cancer Research

Background:

• Breast cancer is a prevalent malignancy in women, with a significant risk of metastatic recurrence.
• Approximately 25% of early-stage breast cancer patients experience metastatic recurrence.

Purpose of the Study:

• To investigate the detection and characterization of circulating tumor cells (CTCs) in primary breast cancer patients.
• To evaluate the clinical relevance of different CTC phenotypes in breast cancer.

Main Methods:

• Four hundred early breast cancer patients were enrolled in two clinical trials.
• Circulating tumor cells (CTCs) were enriched from peripheral blood and characterized by gene expression of cancer cell markers.

Main Results:

• A predominant epithelial phenotype of CTCs was observed in 8.75% of patients.
• De-differentiated characteristics, including mesenchymal and stem cell phenotypes, were found in 37.6% of patients.

Conclusions:

• Epithelial-mesenchymal transition in tumor cells leads to aggressive mesenchymal phenotypes.
• Detecting mesenchymal and cancer stem cells (tumor-initiating cells) is more clinically relevant than simply counting CTCs.
• This study provides a basis for future prognostic evaluations of early-detected CTCs.