Monitoring of disseminated tumor cells in bone marrow in high-risk breast cancer patients treated with high-dose chemotherapy

✍ Scribed by Vilde Drageset; Jahn M. Nesland; Bjorn Erikstein; Eva Skovlund; Hilde Sommer; Gun Anker; Erik Wist; Steinar Lundgren; Jonas Bergh; Gunnar Kvalheim

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: French
• Weight: 139 KB
• Volume: 118
• Category: Article
• ISSN: 0020-7136
• DOI: 10.1002/ijc.21709

✦ Synopsis

Abstract

The present study aimed to investigate the clinical relevance of disseminated tumor cells (DTC) in breast cancer patients before and after high‐dose adjuvant chemotherapy with or without progenitor stem‐cell support. One hundred and eighteen high‐risk stage II breast cancer patients entering the Scandinavian Study Group multicenter trial were randomized to 9 cycles of tailored and dose‐escalated FEC (5‐flurouracil, epirubicin, cyclophosphamide) or 3 cycles of standard FEC followed by high‐dose chemotherapy. Bone marrow (BM) samples at diagnosis and 6 months after completion of chemotherapy were assessed for the presence of cytokeratin positive (CK+) cells. Before treatment, 29% of the patients were CK+ (21% in the dose‐escalated group and 36% in the high‐dose‐group). Six months after treatment, 17% of the patients were CK+ (17 and 16% respectively). Of the 95 patients who were evaluated 6 months after treatment, 60% were consistently CK−. CK+ cells in BM was evaluated as a prognostic and predictive marker and compared to other defined prognostic factors of the primary tumor. Monitoring BM changes at the time of diagnosis and 6 months posttreatment is an independent predictive factor for breast‐cancer‐specific survival (BCS) (p = 0.001). Those who have consistent CK negative (−) BM findings constitute a group of patients with good prognosis. Our results suggest that changes in CK+ cells in BM before and after chemotherapy can be used clinically as a surrogate maker to predict outcome in breast cancer patients. © 2005 Wiley‐Liss, Inc.