Department of Medical Oncology, University General Hospital of Heraklion, P.O. Box 1352, Voutes, 71110, Heraklion, Crete, Greece,
Cancer Chemother Pharmacol. 2014 Dec;74(6):1217-25. doi: 10.1007/s00280-014-2598-2. Epub 2014 Oct 26.
To evaluate the effect of front-line chemotherapy on CK-19mRNA+ circulating tumor cells (CTCs) and their relevance in patients with metastatic breast cancer (MBC).
The presence of CK-19mRNA+ CTCs was assessed using a real-time RT-PCR assay in 298 previously untreated patients with MBC before and after the administration of front-line chemotherapy.
CK-19mRNA+ CTCs were detected in the blood of 199 (66.8 %) and 148 (49.7 %) patients before and after chemotherapy, respectively. There was no correlation between the detection of CK-19mRNA+ CTCs after chemotherapy and the various known clinicopathologic parameters except with HER2 status. The incidence of detection of CK-19mRNA+ CTCs was significantly decreased after the administration of 3 (47.8 %; p < 0.001) or 6 (44.3 %; p = 0.001) chemotherapy cycles. The persistent detection of >2.25 CK-19mRNA+ CTCs both before and after chemotherapy (persistently high group) was associated with a significantly (p = 0.003) decreased overall survival. In addition, chemotherapy-induced decrease of CK-19mRNA+ CTCs (≤2.25 CTCs) was associated with a better survival (47 vs 34 months; p < 0.001). Failure of chemotherapy to decrease the CK-19mRNA+ CTCs ≤2.25 was associated with decreased overall survival (HR 1.405, 95 % CI 1.044-1.891; p = 0.025) whereas in multivariate analysis the persistence of >2.25 CTCs both before and after chemotherapy was emerged as an independent prognostic factor (HR 1.661, 95 % CI 1.070-2.579; p = 0.024).
Detection of CK-19mRNA+ CTCs after the completion of front-line chemotherapy in patients with MBC is associated with poor survival and may be a useful tool for the evaluation of front-line chemotherapy.
评估一线化疗对转移性乳腺癌（MBC）患者 CK-19mRNA+循环肿瘤细胞（CTC）的影响及其相关性。
使用实时 RT-PCR 检测 298 例未经治疗的 MBC 患者一线化疗前后 CK-19mRNA+CTC 的存在情况。
化疗前和化疗后分别有 199（66.8%）和 148（49.7%）例患者的血液中检测到 CK-19mRNA+CTC。除 HER2 状态外，化疗后 CK-19mRNA+CTC 的检测与各种已知临床病理参数之间均无相关性。化疗后 CK-19mRNA+CTC 的检出率显著降低（3 个周期：47.8%；p<0.001；6 个周期：44.3%；p=0.001）。化疗前后持续检出>2.25 CK-19mRNA+CTC（持续高组）与总生存期显著降低（p=0.003）显著相关。此外，化疗诱导的 CK-19mRNA+CTC 减少（≤2.25 CTCs）与更好的生存相关（47 个月比 34 个月；p<0.001）。化疗未能使 CK-19mRNA+CTC 减少至≤2.25 与总生存期降低相关（HR 1.405，95%CI 1.044-1.891；p=0.025），而在多变量分析中，化疗前后持续检出>2.25 CTCs 是独立的预后因素（HR 1.661，95%CI 1.070-2.579；p=0.024）。
MBC 患者一线化疗后 CK-19mRNA+CTC 的检测与不良预后相关，可能是评估一线化疗的有用工具。
