Circulating tumor cell status monitors the treatment responses in breast cancer patients: a meta-analysis.
Whether circulating tumor cells (CTCs) can be used as an indicator of treatment response in breast cancer (BC) needs to be clarified. We addressed this issue by a meta-analysis. PubMed, EMBase and Cochrane library databases were searched in June 2016. Effect measures were estimated as pooled risk ratio (RR), odds ratio (OR) or mean difference by fixed- or random-effect models, according to heterogeneity of included studies. In total, 50 studies with 6712 patients were recruited. Overall analysis showed that there was a significant reduction of CTC-positive rate (RR = 0.68, 95% CI: 0.61-0.76, P < 0.00001) after treatment. Subgroup analyses revealed that neoadjuvant treatment, adjuvant treatment, metastatic treatment or combination therapy could reduce the CTC-positive rate, but surgery could not; moreover, the reduction was only found in HER2+ or HER2- patients but not in the triple-negative ones. Reduction of CTC-positive rate was associated with lower probability of disease progression (OR = 0.54, 95% CI: 0.33-0.89, P = 0.01) and longer overall survival period (mean difference = 11.61 months, 95% CI: 8.63-14.59, P < 0.00001) as well as longer progression-free survival period (mean difference = 5.07 months, 95% CI: 2.70-7.44, P < 0.0001). These results demonstrate that CTC status can serve as an indicator to monitor the effectiveness of treatments and guide subsequent therapies in BC.
Breast Disease Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Wen-Ting
WT
Yan
Breast Disease Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Xiang
X
Cui
Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China.
Qing
Q
Chen
Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China.
Ya-Fei
YF
Li
Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University Chongqing 400038, China.
You-Hong
YH
Cui
Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University Chongqing 400038, China.
Yan
Y
Wang
Breast Disease Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Jun
J
Jiang
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000235:genetics* / Q000378:metabolism; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D018450:Disease Progression; D005260:Female; D015870:Gene Expression; D006801:Humans; D008991:Monitoring, Physiologic; D020360:Neoadjuvant Therapy / Q000379:methods; D009360:Neoplastic Cells, Circulating / Q000187:drug effects* / Q000473:pathology; D016017:Odds Ratio; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics* / Q000378:metabolism; D012307:Risk Factors; D016019:Survival Analysis
D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human