The Lynx Group

Circulating Tumor Cells Signal Worse Survival

June 2010, Vol 1, No 2

Brussels—A retrospective study of patients with metastatic breast cancer shows that the number of circulating tumor cells in the patient’s bloodstream prognosticates the length of their survival, information that can be used to adjust treatment at the end of life.

A team of researchers, including Antonio Giordano, MD, conducted this research using computer modeling known as an artificial neural network, which was developed at the University of Naples Federico II, Italy, and presented the findings at the IMPAKT Breast Cancer Conference.

The team used the neural network to assess the relationship between increasing numbers of circulating tumor cells and survival for different subgroups of breast cancer. It has been known for the last several years that patients with 5 or more circulating tumor cells in 7.5 mL of blood survive on average for less time than those with fewer than 5 cells, and this current study attempted to refine this prognostic test.

Dr Giordano and colleagues analyzed 516 consecutive metastatic breast cancer patients at M. D. Anderson Cancer Center, and he discussed the team’s findings in a press release.

“We found that there was a linear relationship between the number of circulating tumor cells and the risk of death in patients with metastatic breast cancer,” Dr Giordano said, and “most importantly, the risk of death after 1 year for patients with 40 circulating tumor cells in 7.5 mL of blood was about twice that for patients with none.

“These results show that the simple cutoff number of 5 circulating tumor cells probably does not adequately represent the complexity of this prognostic variable,” Dr Giordano elaborated. Regarding how this might impact clinical practice, Dr Giordano suggested that monitoring circulating tumor cell numbers should now be considered a standard test for patients with metastatic breast cancer.

Although “the treatment of this condition remains palliative, monitoring of circulating tumor cells can help determine when to modify regimens or discontinue therapy,” he argued. “In other words, this can improve the delivery of personalized therapy.”

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