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  • Longitudinally collected CT...
    Wang, Chun; Mu, Zhaomei; Chervoneva, Inna; Austin, Laura; Ye, Zhong; Rossi, Giovanna; Palazzo, Juan P.; Sun, Carl; Abu-Khalaf, Maysa; Myers, Ronald E.; Zhu, Zhu; Ba, Yanna; Li, Bingshan; Hou, Lifang; Cristofanilli, Massimo; Yang, Hushan

    Breast cancer research and treatment, 01/2017, Letnik: 161, Številka: 1
    Journal Article

    Purpose Circulating tumor cell (CTC) is a well-established prognosis predictor for metastatic breast cancer (MBC), and CTC-cluster exhibits significantly higher metastasis-promoting capability than individual CTCs. Because measurement of CTCs and CTC-clusters at a single time point may underestimate their prognostic values, we aimed to analyze longitudinally collected CTCs and CTC-clusters in MBC prognostication. Methods CTCs and CTC-clusters were enumerated in 370 longitudinally collected blood samples from 128 MBC patients. The associations between baseline, first follow-up, and longitudinal enumerations of CTCs and CTC-clusters with patient progression-free survival (PFS) and overall survival (OS) were analyzed using Cox proportional hazards models. Results CTC and CTC-cluster counts at both baseline and first follow-up were significantly associated with patient PFS and OS. Time-dependent analysis of longitudinally collected samples confirmed the significantly unfavorable PFS and OS in patients with ≥5 CTCs, and further demonstrated the independent prognostic values by CTC-clusters compared to CTC-enumeration alone. Longitudinal analyses also identified a link between the size of CTC-clusters and patient OS: compared to the patients without any CTC, those with 2-cell CTC-clusters and ≥3-cell CTC-clusters had a hazard ratio (HR) of 7.96 95 % confidence level (CI) 2.00–31.61, P  = 0.003 and 14.50 (3.98–52.80, P  < 0.001), respectively. Conclusions In this novel time-dependent analysis of longitudinally collected CTCs and CTC-clusters, we showed that CTC-clusters added additional prognostic values to CTC enumeration alone, and a larger-size CTC-cluster conferred a higher risk of death in MBC patients.