TY - JOUR
T1 - Relationship between lymphocytopenia and circulating tumor cells as prognostic factors for overall survival in metastatic breast cancer
AU - De Giorgi, Ugo
AU - Mego, Michal
AU - Scarpi, Emanuela
AU - Giuliano, Mario
AU - Giordano, Antonio
AU - Reuben, James M.
AU - Valero, Vicente
AU - Ueno, Naoto T.
AU - Hortobagyi, Gabriel N.
AU - Cristofanilli, Massimo
N1 - Funding Information:
Massimo Cristofanilli received a grant from the State of Texas Rare and Aggressive Breast Cancer Research Program .
Funding Information:
This analysis was supported in part by the Nellie B. Connally Breast Cancer Research UK Fund. The authors thank Dr Ian Seymour for manuscript editing.
PY - 2012/8
Y1 - 2012/8
N2 - Introduction: Lymphocytopenia and circulating tumor cells (CTCs) have been reported as independent prognostic factors for overall survival (OS) in metastatic breast cancer (MBC), and both have been associated with bone metastases. Our objective was to compare the prognostic significance of lymphocytopenia, CTC count, and extensive bone metastases (> 2 lesions) assessed by fluorine-18 (18F) fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in patients with MBC. Patients and Methods: This is a retrospective study that included patients with MBC who were starting a new line of systemic therapy. The study population consisted of patients treated at the University of Texas MD Anderson Cancer Center between 2004 and 2008 for whom baseline CTC count, lymphocyte counts, and FDG-PET/CT scans were available. Patients were stratified according to estrogen receptor status (positive vs. negative), human epidermal growth factor receptor 2 (HER2) status (amplified vs. constitutive), baseline CTC counts per 7.5 mL of blood (< 5 CTCs/7.5 mL of blood vs. < 5 CTCs/7.5 mL of blood), lymphocytopenia (< 1000 vs. < 1000/μL), and extensive bone metastases (> 2 vs. ≤ 2 lesions). Results: In 195 assessable patients, the median OS was 27 months (range, 1 to > 45 months). In multivariate analysis, lymphocytopenia, < 5 CTCs/7.5 mL of blood, estrogen receptor status, and line of therapy were the only predictive factors for progression-free survival (PFS) (2P =.001, 2P =.032, 2P =.029, and 2P =.002, respectively) and OS (2P =.001, 2P =.009, 2P =.004, and 2P =.024, respectively). Conclusion: CTC measurement and lymphocytopenia are independent prognostic factors for PFS and OS in patients with MBC.
AB - Introduction: Lymphocytopenia and circulating tumor cells (CTCs) have been reported as independent prognostic factors for overall survival (OS) in metastatic breast cancer (MBC), and both have been associated with bone metastases. Our objective was to compare the prognostic significance of lymphocytopenia, CTC count, and extensive bone metastases (> 2 lesions) assessed by fluorine-18 (18F) fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in patients with MBC. Patients and Methods: This is a retrospective study that included patients with MBC who were starting a new line of systemic therapy. The study population consisted of patients treated at the University of Texas MD Anderson Cancer Center between 2004 and 2008 for whom baseline CTC count, lymphocyte counts, and FDG-PET/CT scans were available. Patients were stratified according to estrogen receptor status (positive vs. negative), human epidermal growth factor receptor 2 (HER2) status (amplified vs. constitutive), baseline CTC counts per 7.5 mL of blood (< 5 CTCs/7.5 mL of blood vs. < 5 CTCs/7.5 mL of blood), lymphocytopenia (< 1000 vs. < 1000/μL), and extensive bone metastases (> 2 vs. ≤ 2 lesions). Results: In 195 assessable patients, the median OS was 27 months (range, 1 to > 45 months). In multivariate analysis, lymphocytopenia, < 5 CTCs/7.5 mL of blood, estrogen receptor status, and line of therapy were the only predictive factors for progression-free survival (PFS) (2P =.001, 2P =.032, 2P =.029, and 2P =.002, respectively) and OS (2P =.001, 2P =.009, 2P =.004, and 2P =.024, respectively). Conclusion: CTC measurement and lymphocytopenia are independent prognostic factors for PFS and OS in patients with MBC.
KW - Bone metastases
KW - Circulating tumor cells
KW - Lymphocytopenia
KW - Metastatic breast cancer
KW - PET/CT
KW - Prognostic factors
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U2 - 10.1016/j.clbc.2012.04.004
DO - 10.1016/j.clbc.2012.04.004
M3 - Article
C2 - 22591634
AN - SCOPUS:84864764730
SN - 1526-8209
VL - 12
SP - 264
EP - 269
JO - Clinical breast cancer
JF - Clinical breast cancer
IS - 4
ER -
