First line hormone therapy vs chemotherapy for HR+ HER2- metastatic breast cancer in the phase III STIC CTC trial: clinical choice and validity of CTC count

Date

09 Oct 2016

Session

Breast cancer, metastatic

Presenters

Francois-Clement Bidard

Citation

Annals of Oncology (2016) 27 (6): 68-99. 10.1093/annonc/mdw365

Authors

F. Bidard1, E. Brain1, W. Jacot2, T. Bachelot3, S. Ladoire4, H. Bourgeois5, A. Gonçalves6, H. Naman7, J. Gligorov8, F. Dalenc9, C. Levy10, M. Espie11, J. Ferrero12, E. Luporsi13, M. Sablin1, C. Dubot1, M. Chevrier14, F. Berger14, C. Alix-Panabieres15, J. Pierga1

Author affiliations

  • 1 Medical Oncology, Institut Curie, 75248 - Paris/FR
  • 2 Department Of Medical Oncology, Institut du Cancer de Montpellier (ICM), 34298 - Montpellier/FR
  • 3 Service Oncologie Medicale, Centre Léon Bérard, Lyon/FR
  • 4 Medical Oncology, Centre Georges-François Leclerc (Dijon), Dijon/FR
  • 5 Oncology, Clinique Victor Hugo Le Mans, Le Mans/FR
  • 6 Oncologie Médicale, Institute Paoli Calmettes, 13274 - Marseille/FR
  • 7 Department Of Medical Oncology, Centre azuréen de Cancérologie, Mougins/FR
  • 8 Medical Oncology, APHP, CancerEst, Tenon University Hospital, Paris/FR
  • 9 Medical Oncology, Institut Universitaire du Cancer -Toulouse- Oncopole, Toulouse/FR
  • 10 Oncology, Centre Francois Baclesse, Caen/FR
  • 11 Medical Oncology, Assistance Publique - Hopitaux De Paris, Paris/FR
  • 12 Medical Oncology, Centre Antoine Lacassagne, Nice/FR
  • 13 Medical Oncology, Institut de Cancérologie de Lorraine - Alexis Vautrin, Vandoeuvre les Nancy/FR
  • 14 Biostatistics, Institut Curie, 75248 - Paris/FR
  • 15 Laboratory Of Rare Human Circulating Tumor Cells, University Medical Center of Montpellier, 34830 - Montpellier/FR
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Background

In patients (pts) diagnosed with HR+ HER2- metastatic BC the choice between by front-line hormone therapy (HT, favored option) or chemotherapy (CT) is based on prognostic factors that are overpassed by CTC count. The STIC CTC trial is a large multicentric phase III randomized trial comparing two strategies to choose the front-line treatment type: decision by clinician vs by CTC levels.

Methods

Clinical/pathological characteristics were registered at time of inclusion, together with the a priori treatment preferred by clinicians (HT or CT). CTC count was then performed by CellSearch® and pts were randomized between a priori treatment and CTC-driven treatment (HT if

Results

This analysis was performed on 530 randomized pts. Main adverse prognostic factors were PS = 2 or 3 (7%), liver (20%) or pleuropulmonary (37%) metastases, >= 3 metastatic sites (34%), lymphocytopenia (39%). HT was the a priori treatment for 371 pts (70%) and CT for 159 pts (30%). Characteristics independently associated with the a priori choice were: age (p = 0.01), center (p 

Conclusions

In the absence of any predictive factor, treatment decision is influenced by numerous prognostic factors, among which CTC count appears to play a central role. Patients are followed up to compare the outcome of CTC-driven decision vs a priori clinical decision.

Clinical trial identification

NCT01710605

Legal entity responsible for the study

Institut Curie

Funding

INCa

Disclosure

All authors have declared no conflicts of interest.

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