Molecular profiling and predictive value of circulating tumor cells in patients with metastatic breast cancer: an option for monitoring response to breast cancer related therapies.
OBJECTIVE
We analyzed circulating tumor cells (CTC) in blood of metastatic breast cancer patients (n = 42) and determined the ability of this method to predict therapy response.


METHODS
CTC from blood were analyzed before and during therapy for EpCAM, MUC1 and HER2 transcripts with the AdnaTest BreastCancer. The estrogen (ER) and progesterone (PR) receptor expression was assessed by RT-PCR.


RESULTS
The overall detection rate for CTC was 52% (thereof 86% EpCAM; 86% MUC1; 32% HER2; 35% ER; 12% PR). CTC were ER, PR and HER2 negative in 45% (ER), 78% (PR) and 60% (HER-2) of patients with steroid receptor-positive tumors. 29% of patients with HER2-negative tumors had HER2-positive CTC. The test predicted therapy response in 78% of all cases. Persistence of CTC significantly correlated with shorter overall survival (P = 0.005).


CONCLUSIONS
Molecular profiling of CTC may offer superior prognostic information with regard to risk assessment for recurrence and predictive judgement of therapeutical regimens.
Tewes
Mitra
M
Department of Internal Medicine (Cancer Research), University Hospital Essen, University of Duisburg-Essen, 45122, Essen, Germany.
Aktas
Bahriye
B
Welt
Anja
A
Mueller
Siemke
S
Hauch
Siegfried
S
Kimmig
Rainer
R
Kasimir-Bauer
Sabine
S
D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000235:genetics; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000235:genetics*; D001943:Breast Neoplasms / Q000097:blood* / Q000188:drug therapy; D018270:Carcinoma, Ductal, Breast / Q000097:blood / Q000188:drug therapy; D018275:Carcinoma, Lobular / Q000097:blood / Q000188:drug therapy; D018276:Carcinoma, Medullary / Q000097:blood / Q000188:drug therapy; D015815:Cell Adhesion Molecules / Q000235:genetics; D000071858:Epithelial Cell Adhesion Molecule; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008875:Middle Aged; D018396:Mucin-1 / Q000235:genetics; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D012333:RNA, Messenger / Q000235:genetics; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate
D000951:Antigens, Neoplasm; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D015815:Cell Adhesion Molecules; D000071858:Epithelial Cell Adhesion Molecule; D018396:Mucin-1; D012333:RNA, Messenger; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C499379:EPCAM protein, human; C060192:MUC1 protein, human