American Association for Cancer Research
10780432ccr170255-sup-177509_3_supp_4103406_5rl7v5.pdf (215.82 kB)

Supplementary Figure S3 from Prognostic Impact of Circulating Tumor Cells for Breast Cancer Patients Treated in the Neoadjuvant "Geparquattro" Trial

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posted on 2023-03-31, 20:27 authored by Sabine Riethdorf, Volkmar Müller, Sibylle Loibl, Valentina Nekljudova, Karsten Weber, Jens Huober, Tanja Fehm, Iris Schrader, Jörn Hilfrich, Frank Holms, Hans Tesch, Christian Schem, Gunter von Minckwitz, Michael Untch, Klaus Pantel

Supplementary Figure S3: Kaplan Meier plots for disease-free (DFS) and overall survival (OS) according to CTC detection after NT. (A, B) DFS, analysis of patients with HER2-positive tumors (A) and of patients with triple negative tumors (B) at cut-off {greater than or equal to}2 CTCs/7.5 mL, (C, D) OS, analysis of patients with HER2-positive tumors (C) and of patients with triple negative tumors (D) at cut-off {greater than or equal to}2 CTCs/7.5 mL.


Walter Schulz Stiftung



Purpose: This study aimed to evaluate the prognostic impact of circulating tumor cells (CTC) detected in patients with operable or locally advanced breast cancer before and after neoadjuvant therapy (NT) within the clinical trial GeparQuattro.Experimental Design: Data on CTCs enumerated with the CellSearch system were available for 213 and 207 patients before and after NT, respectively. Associations of CTCs with disease-free survival (DFS) and overall survival (OS) were analyzed by nonparametric Kaplan–Meier estimates and parametric Cox regression.Results: After a median follow-up of 67.1 months, the detection of ≥1 CTC/7.5 mL and ≥2 CTCs/7.5 mL before NT was associated with reduced DFS (P = 0.031 and P < 0.0001, respectively) and OS (P = 0.0057 and P < 0.0001, respectively), whereas CTCs detected after NT did not correlate with DFS or OS. In parametric univariate and multivariate Cox models, ≥1 CTC/7.5 mL, ≥2 CTCs/7.5 mL, and absolute CTC numbers before NT revealed to be independent prognostic parameters of DFS and OS. CTC-negative patients with pathologic complete response (pCR) exhibited the best prognosis, whereas those with CTCs and less tumor response were at high risk of tumor relapse. In HER2 (ERBB2)-positive and triple-negative patients, ≥2 CTCs/7.5 mL detected before NT also were significantly associated with worse DFS and OS.Conclusions: Detection of CTCs before NT is an independent prognostic factor of impaired clinical outcome, and combined with pCR, it could be helpful to stratify breast cancer patients for therapeutic interventions. Clin Cancer Res; 23(18); 5384–93. ©2017 AACR.

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