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CTC Status Predicts RT Benefit in Early-Stage Breast Cancer

CTC status linked to longer overall survival in those undergoing breast conserving surgery

THURSDAY, May 3, 2018 (HealthDay News) — Circulating tumor cell status is predictive of radiotherapy (RT) benefit in early-stage breast cancer, according to a study published online May 3 in JAMA Oncology.

Chelain R. Goodman, M.D., Ph.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues included data from the National Cancer Database (NCDB; 1,697 patients) and the SUCCESS clinical trial (1,516 patients) to examine whether CTC status is predictive of radiotherapeutic benefit in early-stage breast cancer.

The researchers detected CTCs in 23.5 and 19.4 percent of the NCDB and SUCCESS cohorts, respectively. The correlation of RT with survival was dependent on CTC status in the NCDB cohort; in the SUCCESS cohort, the correlation with disease-free survival was dependent on CTC status. RT correlated with longer OS in patients with CTCs in the NCDB cohort (time ratio [TR], 2.04), but not in patients without CTCs. CTC-positive patients treated with RT had longer local recurrence-free survival, disease-free survival, and overall survival in the SUCCESS cohort (TRs, 2.73, 3.03, and 1.83, respectively). For patients from both cohorts who underwent breast-conserving surgery, RT correlated with longer OS in those with CTCs (TR, 4.37), but not in those without. There was no correlation for RT with overall survival after mastectomy in CTC-positive or CTC-negative patients.

“These results are hypothesis generating; a prospective trial evaluating CTC-based management for RT after breast-conserving surgery in women with early-stage breast cancer is warranted,” the authors write.

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