Abstract

BackgroundCirculating tumor cell (CTC) count have prognostic role for metastatic breast cancer (MBC). No clear biomarkers can guide selection of chemotherapy (CT) or endocrine therapy (ET) in 1st-line setting of hormone-receptor positive and human epidermal growth factor receptor 2 negative (HR+HER2−) MBC. The present study investigated the prognostic role CT or ET according to the CTC count in HR+HER2− MBC.MethodsWe consecutively collected the data of 53 HR+HER2− MBC patients who received 1st-line CT or ET, who had CTC count detected by our peptide-based nanomagnetic CTC isolation system (Pep@MNPs) from January 2014 to December 2015. The clinicopathological characteristics according the CTC count and 1st-line ET vs. CT were compared. Follow-up was conducted every 6 months. The primary endpoint was progression-free survival (PFS) and overall survival (OS). A Cox regression analysis was conducted to determine the prognostic roles of CTC and 1st-line therapy of ET vs. CT for PFS and OS.ResultsThe median CTC count of the 53 patients was 2 (range, 0–18). The clinicopathological characteristics of the patients in the CTC count <2 group and the CTC count ≥2 group were similar. The patients with a CTC count <2 had a significantly longer PFS than those with a CTC count ≥2 (P=0.005, hazard ratio =4.138, 12.1 vs. 7.1 months). The patients who received CT had a significantly longer PFS than those who received ET (P=0.041, hazard ratio =2.721, 9.9 vs. 7.2 months). In the CTC count ≥2 group, the patients who received CT had a significantly longer PFS than those who received ET (P=0.048, hazard ratio =2.475, 8.7 vs. 6.3 months). In the CTC count <2 group, there was no significant difference in PFS between the CT and ET groups (P=0.071). Additionally, the CTC count had no significant effect on OS (P=0.116, hazard ratio =2.391, 54.2 vs. 34.2 months).ConclusionsThe present study showed that CTC count determined by the Pep@MNP system confirmed the prognostic value in the HR+HER2− MBC patients. And it might be helpful in choosing a 1st-line treatment of CT or ET for HR+HER2− MBC patients.

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