Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Oncologist. 2024 Jan 5;29(1):e25-e37. doi: 10.1093/oncolo/oyad195.
The association between different phenotypes and genotypes of circulating tumor cells (CTCs) and efficacy of neoadjuvant chemotherapy (NAC) remains uncertain. This study was conducted to evaluate the relationship of FTH1 gene-associated CTCs (F-CTC) with/without epithelial-mesenchymal transition (EMT) markers, or their dynamic changes with the efficacy of NAC in patients with non-metastatic breast cancer.
This study enrolled 120 patients with non-metastatic breast cancer who planned to undergo NAC. The FTH1 gene and EMT markers in CTCs were detected before NAC (T0), after 2 cycles of chemotherapy (T1), and before surgery (T2). The associations of these different types of CTCs with rates of pathological complete response (pCR) and breast-conserving surgery (BCS) were evaluated using the binary logistic regression analysis.
F-CTC in peripheral blood ≥1 at T0 was an independent factor for pCR rate in patients with HER2-positive (odds ratio [OR]=0.08, 95% confidence interval [CI], 0.01-0.98, P = .048). The reduction in the number of F-CTC at T2 was an independent factor for BCS rate (OR = 4.54, 95% CI, 1.14-18.08, P = .03).
The number of F-CTC prior to NAC was related to poor response to NAC. Monitoring of F-CTC may help clinicians formulate personalized NAC regimens and implement BCS for patients with non-metastatic breast cancer.
循环肿瘤细胞（CTC）的不同表型和基因型与新辅助化疗（NAC）的疗效之间的关系尚不确定。本研究旨在评估 FTH1 基因相关 CTC（F-CTC）与/或上皮-间充质转化（EMT）标志物的关系，或其动态变化与非转移性乳腺癌患者 NAC 疗效的关系。
本研究纳入了 120 名计划接受 NAC 的非转移性乳腺癌患者。在 NAC 前（T0）、化疗 2 周期后（T1）和手术前（T2）检测 FTH1 基因和 CTC 中的 EMT 标志物。使用二项逻辑回归分析评估这些不同类型的 CTCs 与病理完全缓解（pCR）和保乳手术（BCS）率的相关性。
T0 时外周血中 F-CTC≥1 是 HER2 阳性患者 pCR 率的独立因素（优势比[OR]=0.08，95%置信区间[CI]，0.01-0.98，P=0.048）。T2 时 F-CTC 数量减少是 BCS 率的独立因素（OR=4.54，95%CI，1.14-18.08，P=0.03）。
NAC 前 F-CTC 的数量与 NAC 反应不良有关。监测 F-CTC 可能有助于临床医生制定个体化 NAC 方案，并为非转移性乳腺癌患者实施 BCS。
