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.
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
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
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
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All authors have declared no conflicts of interest.