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早期乳腺癌循环肿瘤细胞状态与新辅助化疗疗效相关性的前瞻性研究。

Prospective study of the relevance of circulating tumor cell status and neoadjuvant chemotherapy effectiveness in early breast cancer.

作者信息

Ni Chao, Shen Yimin, Fang Qingqing, Zhang Min, Yuan Hongjun, Zhang Jingxia, Zhong Miaochun, Zheng Yajuan

机构信息

Department of Breast Surgery (Surgical Oncology), The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

Key Laboratory of Tumor Microenvironment and Immune Therapy, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

出版信息

Cancer Med. 2020 Apr;9(7):2290-2298. doi: 10.1002/cam4.2876. Epub 2020 Feb 4.

Abstract

Although unequivocal evidence has shown the prognostic relevance of circulating tumor cells (CTCs) in patients with metastatic breast cancer (MBC), less evidence is available for its significance in neoadjuvant chemotherapy (NCT) in early breast cancer (BC). Here we conducted an analysis of individual data from 86 patients confirmed as invasive BC by core-needle biopsy in Zhejiang Provincial People's Hospital between June 2013 and January 2017. The CTCs were assessed at the time after diagnosis and before surgery with the CanPatrol technique. The median follow-up duration was 46.3 months. CTCs were detected in 37.2% of all patients (29/78) at baseline, and the presence of CTCs was associated with tumor size, tumor stage, and molecular classification. After NCT, the CTC-positive patients were dropped from 29 to 8, and the EC-T (epirubicin/cyclophosphamide followed by docetaxel) and TEC (docetaxel/epirubicin/cyclophosphamide) strategies reduce CTC-positive patients from 16 to 3 and 13 to 5, respectively. The CTC-negative conversion rates were similar in ER/PR+ HER2+ (5/7, 71.4%), ER/PR- HER2+ (8/11, 72.7%), and TNBC (7/10, 70%) during NCT. In addition, we explored the association between CTC-negative conversion and objective response rate (partial response and complete response, ORR) and pathological complete response rate (pCR), and our results indicate that ORR was higher in patients with positive CTCs and converted to negative after NCT (ORR, P = .013; pCR, P = .0608). Our study preliminarily highlights the relevance of CTC status and NCT effectiveness in early BC using the CanPatrol system.

摘要

尽管明确的证据已表明循环肿瘤细胞(CTC)在转移性乳腺癌(MBC)患者中的预后相关性,但关于其在早期乳腺癌(BC)新辅助化疗(NCT)中的意义的证据较少。在此,我们对2013年6月至2017年1月期间在浙江省人民医院经粗针活检确诊为浸润性BC的86例患者的个体数据进行了分析。在诊断后和手术前使用CanPatrol技术评估CTC。中位随访时间为46.3个月。在基线时,37.2%(29/78)的患者检测到CTC,CTC的存在与肿瘤大小、肿瘤分期和分子分类相关。新辅助化疗后,CTC阳性患者从29例降至8例,EC-T(表柔比星/环磷酰胺序贯多西他赛)和TEC(多西他赛/表柔比星/环磷酰胺)方案分别将CTC阳性患者从16例降至3例和从13例降至5例。在新辅助化疗期间,ER/PR+HER2+(5/7,71.4%)、ER/PR-HER2+(8/11,72.7%)和三阴性乳腺癌(TNBC)(7/10,70%)的CTC阴性转化率相似。此外,我们探讨了CTC阴性转化与客观缓解率(部分缓解和完全缓解,ORR)和病理完全缓解率(pCR)之间的关联,我们的结果表明,新辅助化疗后CTC阳性并转化为阴性的患者的ORR更高(ORR,P = 0.013;pCR,P = 0.0608)。我们的研究初步强调了使用CanPatrol系统时CTC状态与早期BC新辅助化疗疗效的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9fc/7131845/8ba9900cbb22/CAM4-9-2290-g001.jpg

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