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Chemosensitivity profile assay of circulating cancer cells: prognostic and predictive value in epithelial tumors
Author(s) -
Gazzaniga Paola,
Naso Giuseppe,
Gradilone Angela,
Cortesi Enrico,
Gandini Orietta,
Gianni Walter,
Fabbri Maria Agnese,
Vincenzi Bruno,
di Silverio Franco,
Frati Luigi,
Aglianò Anna Maria,
Cristofanilli Massimo
Publication year - 2010
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.24953
Subject(s) - medicine , circulating tumor cell , oncology , chemotherapy , cancer , drug resistance , predictive marker , adjuvant , breast cancer , metastatic breast cancer , prospective cohort study , metastasis , biology , microbiology and biotechnology
The prognostic value associated with the detection of circulating tumor cells (CTCs) in metastatic breast cancer by the CellSearch™ technology raise additional issues regarding the biological value of this information. We postulated that a drug‐resistance profile of CTCs may predict response to chemotherapy in cancer patients and therefore could be used for patient selection. One hundred 5 patients with diagnosis of carcinoma were enrolled in a prospective trial. CTCs were isolated from peripheral blood, and positive samples were evaluated for the expression of a panel of genes involved in anticancer drugs resistance. The drug‐resistance profile was correlated with disease‐free survival (DFS; patients in adjuvant setting) and time to progression (TTP; metastatic patients) in a 24‐months follow‐up. Objective response correlation was a secondary end point. Fifty‐one percent of patients were found positive for CTCs while all blood samples from healthy donors were negative. The drug‐resistance profile correlates with DFS and TTP ( p < 0.001 in both). Sensitivity of the test: able to predict treatment response in 98% of patients. Specificity of the test: 100%; no sample from healthy subject was positive for the presence of CTCs. Positive and negative predictive values were found to be 96.5 and 100%, respectively. We identified a drug‐resistance profile of CTCs, which is predictive of response to chemotherapy, independent of tumor type and stage of disease. This approach may represent a first step toward the individualization of chemotherapy in cancer patients.