title: Clinical application of circulating tumor cells in breast cancer: overview of the current interventional trials.
abstract: In 2004, circulating tumor cells (CTC) enumeration by the CellSearch® technique at baseline and during treatment was reported to be associated with prognosis in metastatic breast cancer patients. In 2008, the first evidence of the impact of CTC detection by this technique on survival of cM0(i+) patients were reported. These findings were confirmed by other non-interventional studies, whereas CTC were also investigated as a surrogate for tumor biology, mainly for HER2 expression/amplification. The aim of this report is to present the current prospective large interventional studies that have been specifically designed to demonstrate that CTC enumeration/characterization may improve the management of breast cancer patients: STIC CTC METABREAST (France) and Endocrine Therapy Index (USA) assess the CTC-guided hormone therapy vs chemotherapy decision in M1 patients; SWOG0500 (USA) and CirCe01 (France) assess the CTC count changes during treatment in metastatic patients; DETECT III (M1 patients, Germany) and Treat CTC (cM0(i+) patients, European Organization for Research and Treatment of Cancer/Breast International Group) assess the use of anti-HER2 treatments in HER2-negative breast cancer patients selected on the basis of CTC detection/characterization. These trials have different designs in various patient populations but are expected to be the pivotal trials for CTC implementation in the routine management of breast cancer patients.
authors.affiliation: Department of Medical Oncology, Institut Curie, Paris, France. fcbidard@curie.fr
authors.forename: François-Clément
authors.initials: FC
authors.lastname: Bidard
authors.forename: Tanja
authors.initials: T
authors.lastname: Fehm
authors.forename: Michail
authors.initials: M
authors.lastname: Ignatiadis
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Smerage
authors.forename: Catherine
authors.initials: C
authors.lastname: Alix-Panabières
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Janni
authors.forename: Carlo
authors.initials: C
authors.lastname: Messina
authors.forename: Costanza
authors.initials: C
authors.lastname: Paoletti
authors.forename: Volkmar
authors.initials: V
authors.lastname: Müller
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Hayes
authors.forename: Martine
authors.initials: M
authors.lastname: Piccart
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Pierga
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D002986:Clinical Trials as Topic; D005060:Europe; D005260:Female; D006801:Humans; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D016896:Treatment Outcome; D014481:United States
chemical_list: D000970:Antineoplastic Agents