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Speedier Look at Advanced Breast Cancer
Aug. 18, 2004 - The number of tumor cells in the blood of women with advanced-stage breast cancer predicts the success of their treatment, according to a new study in The New England Journal of Medicine.
Women with breast cancer who have fewer than five tumor cells per 7.5 milliliters of blood have almost seven months during which no cancer is found, compared with less than three months of women with five or more circulating tumor cells.
The women with fewer than five circulating tumor cells in their blood samples also lived longer, surviving for 18 months compared with about 10 months for women with five or more circulating tumor cells.
The findings come from a study done at 20 centers in the U.S. Massimo Cristofanilli, MD, of the University of Texas M.D. Anderson Cancer Center in Houston, led the research, which used new technology called the CellSearch System to detect tumor cells in blood.
The system works by detecting cancer cells that detach from solid tumors and enter the blood. These cells aren't usually found in the blood of healthy women, so when they show up in blood, it usually suggests that they are cancerous cells on the move from breast tissue. Their presence and number give physicians information that can help predict response to therapy in women with breast cancer.
In the study, 177 women with breast cancer that had spread outside of the breast tissue (metastatic breast cancer) were tested for levels of circulating tumor cells before starting a new cancer treatment and at their first follow-up visit.
About half the women had elevated levels of circulating tumors. Of those women, 30% still had higher numbers of circulating cells three to five weeks into their new treatment.
In these women, cancer progressed very rapidly, compared with women whose circulating tumor cell levels dropped during the first few weeks of their new treatment or were low at the start of the study.
Ten patients who died before their first follow-up visit had "high to extremely high" counts of circulating tumor cells in their initial blood sample, the researchers write.
The researchers call circulating tumor cell levels useful predictors of survival.
However, they stress that their results may not apply to women who don't have evidence of breast cancer or those starting a new regimen of hormone therapy, immunotherapy, or both.
Likewise, the researchers caution that their findings don't support using the new technology to screen and detect new or metastatic breast cancer.
If further studies prove the technology useful, it could shorten the wait before women with advanced-stage cancer can get feedback on new treatments. Currently, it takes three or four months and a series of tests including bone scans and X-rays to get that information.
Time is vital for women with advanced-stage breast cancer, who face low survival rates.
The company that developed CellSearch, Immunicon Corp., funded the study, and several Immunicon researchers were involved in the study.
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October is National Breast Cancer Awareness Month, and a new study reveals why a high number of women with the disease still prefer to have the entire breast surgically removed instead of just the tumor. It's not always because doctors recommend it.
