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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

5349 - Prognostic implications of circulating tumor cells (CTCs) after neoadjuvant chemotherapy for triple negative breast cancer (TNBC)

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Presenters

Carolyn Hall

Citation

Annals of Oncology (2018) 29 (suppl_8): viii58-viii86. 10.1093/annonc/mdy270

Authors

C. Hall1, K.R. Hess2, L. Ravenberg3, A. Clayborn4, G.M. Rauch5, R. Candelaria6, E.A. Mittendorf7, S.L. Moulder8, A. Thompson9, A. Lucci9

Author affiliations

  • 1 Breast Surgical oncology, MD Anderson, 77030 - houston/US
  • 2 Biostatistics, The University of Texas MD Anderson Cancer Center, Houston/US
  • 3 Breast Medical Oncology, MD Anderson, Houston/US
  • 4 Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 77030 - Houston/US
  • 5 Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston/US
  • 6 Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 77030 - Houston/US
  • 7 Surgical oncology, Dana-Farber Cancer Insitute, Boston/US
  • 8 Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 77030-4095 - Houston/US
  • 9 Breast Surgical oncology, The University of Texas M. D. Anderson Cancer Center, 77035 - Houston/US
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Resources

Abstract 5349

Background

ARTEMIS (A Randomized, TNBC Enrolling trial to confirm Molecular profiling Improves Survival) is a randomized trial to determine if precision guided neoadjuvant chemotherapy (NACT) impacts rates of pathologic complete response in the breast and axillary nodes (pCR). We hypothesized that CTCs in peripheral blood at the time of surgery, after completion of NACT, would be prognostic in TNBC.

Methods

Venous Blood taken following completion of NACT and immediately prior to surgery was assessed for CTCs after NACT as part of two IRB approved studies, ARTEMIS (2014 – 0185/PA15-1050) and LAB04-0698. CTCs (per 7.5 ml blood) were identified using the Cell Search® System (Menarini Silicon Biosystems). Samples with one or more cells having morphologic criteria for malignancy were deemed CTC+. Log-rank test and Cox regression analysis were applied to evaluate associations between CTC+, pCR, and overall survival.

Results

pCR was achieved in 24/68 (35%) patients with TNBC. Twenty four patients (35%) were CTC+. 3 year overall survival was evaluated in 4 groups of patients: pCR-no CTCs (n = 20), pCR-CTC + (n = 4), non-pCR-no CTCs (n = 24) and non-pCR-CTC + (n = 20). Three year OS was higher in the pCR-no CTCs cohort (100%), compared to pCR-CTC + (50%), non-pCR-no CTCs (83%), non-pCR-CTC + (19%); log rank p < 0.0001. In this data set, the presence of CTCs was associated with significant risk of death at 3 years [hazard ratio of 12.3 (95% CI 3.4-454, p = 0.00002)], whereas a favorable, but non-significant trend was noted for pCR [hazard ratio of 0.2 (95% CI 0.0, 1.4, p = 0.11)].

Conclusions

The presence of CTCs at the time of surgery after NACT has prognostic significance beyond that of pCR and should be considered in evaluation of patients for adjuvant clinical trials.

Clinical trial identification

Legal entity responsible for the study

University of Texas, MD Anderson.

Funding

University of Texas, MD Anderson.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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