gdc
Breast CancerWeb Exclusives

Blood-Based Biopsy Can Predict Breast Cancer Recurrence

In patients with HR-positive breast cancer, a positive circulating tumor cells assay result was associated with nearly a 20-fold increased risk for recurrence of disease.

Web Exclusives – February 26, 2018

In the near future, a blood test that measures the number of tumor cells circulating in the blood, sometimes referred to as a “liquid biopsy,” may be used to predict the chance that breast cancer may recur. In a recent study, measuring circulating tumors cells (CTCs) in patients with metastatic breast cancer using a test cleared by the FDA (CELLSEARCH®) was found to be a biomarker that predicted late recurrence among patients with hormone receptor (HR)-positive, HER2-negative early breast cancer.

In this population of patients, late recurrences (defined as those that occur ≥5 years after initial diagnosis) account for approximately 50% of recurrences in HR-positive breast cancers, noted the study’s lead investigator Joseph A. Sparano, MD, Associate Director for Clinical Research, Montefiore Einstein Center for Cancer Care, Albert Einstein Cancer Center, New York, NY.

The results from this study provide “proof of concept” that the presence of CTCs is a biomarker for late recurrence of disease.

“To our knowledge, this is the first report showing that a liquid-based biomarker is robustly prognostic for late recurrence,” said Dr Sparano.

The data also support the concept that therapy for patients might be tailored based on the blood biomarker test results.

This study, the details of which were presented at the 2017 San Antonio Breast Cancer Symposium, included 546 patients drawn from a larger study that tested the effect of adding bevacizumab (Avastin) to chemotherapy as adjuvant treatment following surgery. The patients selected had no recurrence of breast cancer 4.5 to 7.5 years after an initial diagnosis of HER2-negative stage II-III disease.

Thirty-five percent of patients who had blood samples were HR-negative. Eighty-eight percent of patients with estrogen receptor–positive disease were taking endocrine therapy at the time of their CTC sample. At a follow-up of 1.8 years, 4.0% of HR-positive patients and 0.5% of HR-negative patients had a breast cancer recurrence.

Overall, 4.8% of patients had a positive CTC assay result, including 5.1% of HR-positive patients and 4.1% of the HR-negative patients.

In the 353 patients with HR-positive disease, CTC-positive patients had a 21.7-fold higher risk for recurrence compared with the CTC-negative group. The median time to recurrence in CTC-positive patients was 1.6 years. A positive CTC assay was not associated with recurrence in the HR-negative group.

The results were somewhat unexpected, according to Dr Sparano. “We were surprised to see that 5% of patients had CTCs about 5 or more years after their initial diagnosis,” he said. “Although we were expecting that CTC-positive patients would have a higher recurrence rate, we weren’t expecting the risk of recurrence to be this high after a relatively short period of time.”

Further study is needed to confirm the clinical utility of this information, he added. For instance, it may be possible that patients can be spared extended adjuvant endocrine therapy if they have a negative CTC assay, indicating a low risk for recurrence.

Source:
Sparano JA, O’Neill A, Alpaugh K, et al. Circulating tumor cells (CTCs) five years after diagnosis are prognostic for late recurrence in operable stage II-III breast cancer. Presented at: 2017 San Antonio Breast Cancer Symposium; December 5-9, 2017. Abstract GS6-03.

Recommended For You
Breast CancerPatient Advocacy
Finding Our Voices, Telling Our Stories: Metastatic Breast Cancer Advocacy
By Meg Barbor, MPH
Musa Mayer, breast cancer survivor and advocate, was recently recognized for her 25 years of advocacy on behalf of patients with advanced breast cancer. Read Musa’s inspiring story.
Breast CancerNewsworthy
Living Beyond Breast Cancer to Host 12th Annual National Metastatic Breast Cancer Conference in Philadelphia, April 20-22
Hundreds of people with metastatic breast cancer and their caregivers from across the country will attend the 2018 Conference on Metastatic Breast Cancer in Philadelphia on April 20–22, 2018, hosted by Living Beyond Breast Cancer.
Breast CancerNewsworthyWeb Exclusives
Breaking News: Sellas Announces Promising Data on NeuVax in Combination with Herceptin in HER2 1+/2+ Breast Cancer
NeuVax + Herceptin may provide a clinically meaningful benefit to breast cancer patients with low to intermediate HER2-expression.
SlideshowsWeb Exclusives
Testicular Cancer Awareness Month
April is Testicular Cancer Awareness Month! Take a cruise through this slideshow full of facts about testicular cancer, such as the common risk factors and symptoms to look out for. Conquer cancer with knowledge.
Last modified: March 21, 2018

Subscribe to CONQUER: the patient voice® magazine

Receive timely cancer news & updates, patient stories, and more.

Country
Need multiple copies? Click here