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 Poster Display session

225P - Prognostic implications of circulating tumor cells (CTCs) after neoadjuvant chemotherapy for triple negative breast cancer (TNBC)

Presentation Number
225P
Lecture Time
12:45 - 12:45
Speakers
  • Carolyn Hall (houston, US)
Location
Hall A3 - Poster Area Networking Hub, ICM M√ľnchen, Munich, Germany
Date
22.10.2018
Time
12:45 - 13:45

Abstract

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.

Legal entity responsible for the study

University of Texas, MD Anderson.

Funding

University of Texas, MD Anderson.

Disclosure

All authors have declared no conflicts of interest.

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