Department of Medical Cell BioPhysics, Faculty of Science and Technology, University of Twente, Enschede, the Netherlands.
SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA.
JCO Precis Oncol. 2023 Jan;7:e2200372. doi: 10.1200/PO.22.00372.
Circulating tumor cells (CTCs) are strongly prognostic for overall survival (OS) in metastatic breast cancer although additional prognostic biomarkers are needed. We evaluated the complementary prognostic value of tumor-derived extracellular vesicles (tdEVs) next to CTCs.
We applied the open-source ACCEPT software to archived CellSearch images from the prospective clinical trial SWOG0500 to enumerate CTCs and tumor-derived extracellular vesicles (tdEVs) before and after one cycle of chemotherapy.
CTCs enumerated by ACCEPT were strongly correlated with classical ocular enumeration (correlation = 0.98). OS was worse with elevated tdEVs (median OS for high/medium/low groups: 17.1 29.0 43.3 months; < .0001). In patients with longer OS by CTC counts (< 5 CTC/7.5 mL blood), elevated tdEV levels were independently associated with poorer OS (multivariable analysis < .001). OS was also longer for patients with low tdEVs after one cycle of chemotherapy (median OS for high/medium/low group: 10.8 17.8 26.7; < .0001).
This study highlights the complementary prognostic significance of tdEVs in metastatic breast cancer before and after one cycle of chemotherapy.
循环肿瘤细胞（CTCs）对转移性乳腺癌的总生存期（OS）具有很强的预后作用，尽管还需要额外的预后生物标志物。我们评估了 CTC 之外的肿瘤衍生细胞外囊泡（tdEVs）的补充预后价值。
我们应用开源的 ACCEPT 软件对前瞻性临床试验 SWOG0500 的存档 CellSearch 图像进行分析，以在化疗前和化疗后一周期内计数 CTC 和肿瘤衍生的细胞外囊泡（tdEVs）。
ACCEPT 计数的 CTCs 与经典的眼部计数高度相关（相关系数=0.98）。OS 随 tdEVs 的升高而恶化（高/中/低组的中位 OS：17.1 29.0 43.3 个月；<0.0001）。在 CTC 计数较长的患者（<5 CTC/7.5 mL 血液）中，升高的 tdEV 水平与较差的 OS 独立相关（多变量分析<0.001）。化疗后一周期 tdEVs 水平较低的患者 OS 也更长（高/中/低组的中位 OS：10.8 17.8 26.7；<0.0001）。
这项研究强调了 tdEVs 在转移性乳腺癌化疗前后的补充预后意义。
