TY - JOUR
T1 - Clinical relevance of serum HER2 and circulating tumor cell detection in metastatic breast cancer patients
AU - Banys-Paluchowski, Malgorzata
AU - Witzel, Isabell
AU - Riethdorf, Sabine
AU - Rack, Brigitte
AU - Janni, Wolfgang
AU - Fasching, Peter Andreas
AU - Solomayer, Erich Franz
AU - Aktas, Bahriye
AU - Kasimir-Bauer, Sabine
AU - Pantel, Klaus
AU - Fehm, Tanja
AU - Müller, Volkmar
PY - 2017/6
Y1 - 2017/6
N2 - Background/Aim: Presence of circulating tumor cells (CTCs) is associated with impaired survival in metastatic breast cancer (MBC). This study was designed to evaluate whether assessment of serum HER2 (sHER2) levels provide additional prognostic information in MBC. Materials and Methods: Two hundred and fifty-three MBC patients were enrolled in this multicentre trial. CTCs were detected before the start of first- or later-line treatment using the CellSearch system. sHER2 was determined using ELISA. Results: ≥5 CTCs were detected in 122 of 245 evaluable patients (49.8%). One hundred and nineteen of 251 patients (47%) had sHER2 levels above 15 ng/ml. Median overall survival (OS) was 16.3 months in patients with elevated sHER2; median OS in patients with non-elevated sHER2 has not been reached (p=0.001). Patients with =5 CTCs were more likely to present with elevated sHER2 (61% vs. 33% in those with <5 CTC; p<0.001). In patients with HER2- negative tumors, elevated sHER2 was associated with shorter OS and PFS; in HER2-positive patients with OS only. Including sHER2, CTC status and established prognostic factors into a multivariate analysis, only the presence of CTCs and higher-line of therapy remained independent predictors of OS. Conclusion: Elevated levels of sHER2 are associated with worse survival, irrespective of the HER2 status of the tumor. However, sHER2 does not provide additional prognostic information in patients with known CTC status.
AB - Background/Aim: Presence of circulating tumor cells (CTCs) is associated with impaired survival in metastatic breast cancer (MBC). This study was designed to evaluate whether assessment of serum HER2 (sHER2) levels provide additional prognostic information in MBC. Materials and Methods: Two hundred and fifty-three MBC patients were enrolled in this multicentre trial. CTCs were detected before the start of first- or later-line treatment using the CellSearch system. sHER2 was determined using ELISA. Results: ≥5 CTCs were detected in 122 of 245 evaluable patients (49.8%). One hundred and nineteen of 251 patients (47%) had sHER2 levels above 15 ng/ml. Median overall survival (OS) was 16.3 months in patients with elevated sHER2; median OS in patients with non-elevated sHER2 has not been reached (p=0.001). Patients with =5 CTCs were more likely to present with elevated sHER2 (61% vs. 33% in those with <5 CTC; p<0.001). In patients with HER2- negative tumors, elevated sHER2 was associated with shorter OS and PFS; in HER2-positive patients with OS only. Including sHER2, CTC status and established prognostic factors into a multivariate analysis, only the presence of CTCs and higher-line of therapy remained independent predictors of OS. Conclusion: Elevated levels of sHER2 are associated with worse survival, irrespective of the HER2 status of the tumor. However, sHER2 does not provide additional prognostic information in patients with known CTC status.
UR - http://www.scopus.com/inward/record.url?scp=85019699963&partnerID=8YFLogxK
U2 - 10.21873/anticanres.11669
DO - 10.21873/anticanres.11669
M3 - Journal articles
C2 - 28551653
AN - SCOPUS:85019699963
SN - 0250-7005
VL - 37
SP - 3117
EP - 3128
JO - Anticancer Research
JF - Anticancer Research
IS - 6
ER -
