title: Time-Dependent Prognostic Impact of Circulating Tumor Cells Detection in Non-Metastatic Breast Cancer: 70-Month Analysis of the REMAGUS02 Study.
abstract: Introduction. In non-metastatic breast cancer patients, the REMAGUS02 neoadjuvant study was the first to report a significant impact of circulating tumor cells (CTCs) detection by the CellSearch system on the distant metastasis-free survival (DMFS) and overall survival (OS) endpoints. However, these results were only reported after a short follow-up. Here, we present the updated data, with a longer follow-up. Material and Methods. CTC count was performed before and after neoadjuvant chemotherapy in 118 patients and correlated to survival. Results. CTC count results were available before and/or after neoadjuvant chemotherapy in 115 patients. After a median follow-up of 70 months, detection of ≥1 CTC/7.5 mL before chemotherapy (N = 95) was significantly associated with DMFS (P = 0.04) and OS (P = 0.03), whereas postchemotherapy CTC detection (N = 85) had no significant impact. In multivariable analysis, prechemotherapy CTC and triple negative phenotype were the two independent prognostic factors for survival. We observed that the CTC impact is most significant during the first three years of follow-up. Discussion. We confirm that the detection of CTC is independently associated with a significantly worse outcome, but mainly during the first 3-4 years of follow-up. No prognostic impact is seen in patients who are still relapse-free at this moment.
authors.affiliation: Department of Medical Oncology, Institut Curie, 26 rue d'Ulm, 75005 Paris, France ; Laboratory of Circulating Cancer Biomarker, Institut Curie, 26 rue d'Ulm, 75005 Paris, France.
authors.forename: François-Clément
authors.initials: FC
authors.lastname: Bidard
authors.forename: Lisa
authors.initials: L
authors.lastname: Belin
authors.forename: Suzette
authors.initials: S
authors.lastname: Delaloge
authors.forename: Florence
authors.initials: F
authors.lastname: Lerebours
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ngo
authors.forename: Fabien
authors.initials: F
authors.lastname: Reyal
authors.forename: Séverine
authors.initials: S
authors.lastname: Alran
authors.forename: Sylvie
authors.initials: S
authors.lastname: Giacchetti
authors.forename: Michel
authors.initials: M
authors.lastname: Marty
authors.forename: Ronald
authors.initials: R
authors.lastname: Lebofsky
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Pierga