Abstract
10626 Background: While evidence for the prognostic value of circulating tumor cells (CTC) in the adjuvant setting is swiftly increasing the role of tumor markers like CA27.29 in this setting is still controversial. In the SUCCESS Trial CTC and CA27.29 have been measured before, after and 2 years after adjuvant chemotherapy. Our goal was to examine the correlation of these 2 factors at the 3 points in time. Methods: The SUCCESS Trial compared FEC-docetaxel (Doc) vs. FEC-Doc-gemcitabine (Doc-G) regime and 2 vs. 5 year treatment with zoledronat in 3754 patients with primary breast cancer (N+ or high risk). CA27.29 has been measured with ST AIA-PACK Ca27.29 reagent using MUC-1 for AIA-600II (Tosoh Bioscience, Belgium). The cutoff for positivity of CA27.29 was >31 U/ml. CTC were assessed with the CellSearchSystem (Veridex, USA). After immunomagnetic enrichment with an anti-Epcam-antibody, cells were labeled with anti-cytokeratin (8,18,19) and anti-CD45 antibodies to distinguish between epithelial cells and leukocytes. The cutoff for positivity was >1 CTC/15ml. Results: CA27.29 and CTC data are available of 2011 patients before, 1525 after and 1000 pts 2 years after chemotherapy. Before CHT 7.86% of pts were CA27.29 positive and 9.40% were CTC positive. 1.29% were CA27.29 and CTC positive (p=0.0015). After CHT 20.92% of pts were CA27.29 positive and 8.59% were CTC positive. 1.18% were CA27.29 and CTC positive (p=0.0346). 2 years after CHT 2.60% of pts were CA27.29 positive and 7.40% were CTC positive. 0.40% were CA27.29 and CTC positive (p=0.1115). Concerning correlation of positive CA27.29 with other prognostic factors we found a significant (p<0.05) correlation to histology and menopausal status before CHT. After CHT there was a significant correlation to menopausal status only and 2 years after CHT no correlation to any other prognostic factor could be found. Conclusions: In conclusion there seems to be a relationship between CA27.29 and CTC before treatment which resolves in the course of the treatment and beyond. Therefore clarification of the prognostic value of CA27.29 and CTC after adjuvant treatment as independent tools is needed.
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