Circulating tumor cells and response to neoadjuvant paclitaxel and HER2-targeted therapy: A sub-study from the NeoALTTO phase III trial

Hatem A. Azim, Francoise Rothé, Claudia Monica Aura, Malcolm Bavington, Marion Maetens, Ghizlaine Rouas, Geraldine Gebhart, Cristina Gamez, Holger Eidtmann, José Baselga, Martine Piccart-Gebhart, Catherine Ellis, Peter Vuylsteke, Hervé Cure, Julien Domont, Antonella Ferro, Juan Carlos Toral-Peña, Evandro de Azambuja, Christos Sotiriou, Serena Di CosimoMichail Ignatiadis

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The role of circulating tumor cells (CTCs) in HER2-positive breast cancer patients receiving neoadjuvant therapy is unclear. Patients & methods: We describe the CTC detection rate, HER2 phenotyping and pathological complete response (pCR) in patients enrolled in the NeoALTTO phase III trial. Participation in the CTC sub-study was optional. CTC evaluation was performed centrally using CellSearch® at baseline, week 2 and week 18 (prior to surgery) of neoadjuvant therapy. Results: Samples for CTC analysis were available for 51/455 patients randomized. At baseline, week 2 and week 18, we detected ≥1 CTC/22.5ml in 5/46 (11%), 4/41 (10%), and 5/31 (16%) patients and ≥1 HER2-positive CTC/22.5ml in 2/46 (4%), 2/41 (5%), and 3/31 (10%) patients with evaluable samples, respectively. 11/51 patients (21%) had ≥1 CTC/22.5ml in at least one time point. pCR was observed in 3/11 (27.3%) versus 17/40 (42.5%) patients with detectable and no detectable CTCs, respectively (. p=0.36). No pCR was observed in the three patients with detectable HER2-positive CTCs prior to surgery. Conclusion: Numerically lower pCR rates were observed in patients with detectable CTCs, yet the study remains underpowered. A meta-analysis of CTC studies in this setting is warranted.

Original languageEnglish
Pages (from-to)1060-1065
Number of pages6
JournalBreast
Volume22
Issue number6
DOIs
Publication statusPublished - Dec 2013

Keywords

  • Circulating tumor cells
  • HER2-positive breast cancer
  • Lapatinib
  • PCR
  • Trastuzumab

ASJC Scopus subject areas

  • Surgery

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