Circulating tumor cells and response to neoadjuvant paclitaxel and HER2-targeted therapy: A sub-study from the NeoALTTO phase III trial |
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| Authors: | Hatem A. Azim Francoise Rothé Claudia Monica Aura Malcolm Bavington Marion Maetens Ghizlaine Rouas Geraldine Gebhart Cristina Gamez Holger Eidtmann José Baselga Martine Piccart-Gebhart Catherine Ellis Peter Vuylsteke Hervé Cure Julien Domont Antonella Ferro Juan Carlos Toral-Peña Evandro de Azambuja Michail Ignatiadis |
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| Affiliation: | 1. Breast Cancer Translational Research Laboratory, J.C. Heuson, Université Libre de Bruxelles, Institut Jules Bordet, Brussels, Belgium;2. Department of Medicine, BrEAST Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium;3. Laboratory of Molecular Pathology, Vall D''Hebron Institute of Oncology, Barcelona, Spain;4. Frontier Science (Scotland) Ltd, Kincraig, Kingussie, UK;5. Department of Nuclear Medicine, Institut Jules Bordet, Université Libre De Bruxelles, Brussels, Belgium;6. PET Unit of the Instituto de Dianostico por la Imagen (ID), Barcelona, Spain;7. University Hospital Kiel, Kiel, Germany;8. Memorial Sloan Kettering Cancer Center, New York, USA;9. Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium;10. GlaxoSmithKline, Collegeville, PA, USA;11. Department of Oncology, Saint-Elisabeth Hospital, Namur, Belgium;12. Service d''Oncologie, Institut Jean Godinot, Reims Cedex, France;13. Department of Medicine, Institut Gustave Roussy, Villejuif, France;14. Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy;15. Department of Oncology, Hospital Torrevieja, Alicante, Spain;p. Instituto Nazionale Dei Tumori, Milan, Italy |
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| Abstract: | BackgroundThe role of circulating tumor cells (CTCs) in HER2-positive breast cancer patients receiving neoadjuvant therapy is unclear.Patients & methodsWe describe the CTC detection rate, HER2 phenotyping and pathological complete response (pCR) in patients enrolled in the NeoALTTO phase III trial. Participation in the CTC sub-study was optional. CTC evaluation was performed centrally using CellSearch® at baseline, week 2 and week 18 (prior to surgery) of neoadjuvant therapy.ResultsSamples for CTC analysis were available for 51/455 patients randomized. At baseline, week 2 and week 18, we detected ≥1 CTC/22.5 ml in 5/46 (11%), 4/41 (10%), and 5/31 (16%) patients and ≥1 HER2-positive CTC/22.5 ml in 2/46 (4%), 2/41 (5%), and 3/31 (10%) patients with evaluable samples, respectively. 11/51 patients (21%) had ≥1 CTC/22.5 ml in at least one time point. pCR was observed in 3/11 (27.3%) versus 17/40 (42.5%) patients with detectable and no detectable CTCs, respectively (p = 0.36). No pCR was observed in the three patients with detectable HER2-positive CTCs prior to surgery.ConclusionNumerically lower pCR rates were observed in patients with detectable CTCs, yet the study remains underpowered. A meta-analysis of CTC studies in this setting is warranted. |
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| Keywords: | Circulating tumor cells pCR HER2-positive breast cancer Trastuzumab Lapatinib |
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