Circulating tumor cell (CTC) and CA2729 as predictors of outcome in patients with metastatic breast cancer (MBC) in the prospective TBCRC 005 biomarker study.

作者：Aditya Bardia, Ping Huang, Z. Zhang, Lori J. Sokoll, J. N. Ingle, LA Carey, NU Lin, Rachita Nanda, Kumar Visvanathan, Antonio C. Wolff · 发表于：Journal of Clinical Oncology · 年份：2010 · DOI：10.1200/jco.2010.28.15_suppl.1001 · 被引用次数：2 · 研究领域：Cancer Genomics and Diagnostics、Advanced Breast Cancer Therapies、Cancer Cells and Metastasis

1001 Background: Limited data support using circulating tumor markers (e.g., CA2729) as adjuncts to clinical/imaging studies to monitor MBC during active Rx (Harris, JCO 2007). CTC independently predicts survival (Cristofanilli, NEJM 2004), and an ongoing randomized trial is testing its clinical utility. However, the joint and comparative contribution of these two assays as outcome predictor(s) have yet to be tested. Methods: TBCRC 005 is an IRB-approved prospective trial testing the predictive role of serum DNA methylation in MBC patients starting new Rx. CA2729 (local labs, high if ≥ 38 units/mL serum) was collected at baseline and repeated if high in wk 3-4. CTC (CellSearch, high if ≥ 5 CTC/7.5 mL blood) was collected at baseline and at wk 3-4. Logistic regression/ROC and Cox regression tested marker association with progressive disease (PD) at first restaging (8-12 wks) and with PFS/OS, respectively. Results: Baseline CTC (52% or 59 high) and CA2729 (82% or 93 high) were available in 113 women (median age 56; white 86%; < 2 prior Rx 31%; ER+ 66%, HER2+ 21%, triple neg 18%). High CTC (but not high CA2729) was associated with worse PFS/OS. In 82 women with high baseline CA2729, this assay was repeated at wk 3-4 and in 60 of them CTC was also repeated. Change in CTC (but not in CA2729) was highly correlated with baseline CA2729 and CTC. Change in CA2729 (but not in CTC) independently predicted PD/PFS/OS (p=0.02/0.0003/0.002, n=60) after adjusting for known prognostic factors...