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乳癌看數據

1.6  乳癌看數據

看數據: CTC vs. 傳統癌症指數(CEA, CA153)更能預測療效?

 

歐洲一個聯合臨床研究, 綜合了17個癌症中心的數據, 為期九年, 分析了1944個晚期乳癌患者, 發現治療前和治療後的CTC數量改變與生存期有顯著關係, CTC數量的改變能預測療效。在治療前, 1944個患者中的1029個患者沒有CTC (53%)。研究發現, 在開始治療後的第3至5週(大概一至兩個週期的治療), 如果患者的CTC增多, 他們的死亡率比較高, 死亡風險比率是沒有CTC增多的患者的2.26倍(harzard ratio=2.26)。如果治療後第6至8週CTC增多, 患者的死亡風險率是沒有CTC增多的患者的2.91倍。研究人員同時比較傳統癌症指數CEA, CA153,  如果患者治療後CEA, CA153增多, 死亡風險率只有些微增多 - 是沒有增多的患者的1.54-1.59倍。當研究人員再進一步把其他因素(例如患者腫瘤的分期, 分類, 治療病史, 癌症擴散數據)作分析, 去建立一個臨床病理模型, 從而預測療效及生存期, 發現癌症指數(CEA, CA153) 無助於改善預測, CTC對預測療效有顯著幫助(p<0.0001)。研究證實CTC是傳統檢測的有力輔助 , CTC比傳統癌症指數CEA/CA153更能反映生存期。

References:

Clinical validity of circulating tumour cells in patients with metastatic breast cancer: a pooled analysis of individual patient data.Lancet Oncol. 2014 Apr;15(4):406-14. doi: 10.1016/S1470-2045(14)70069-5. Epub 2014 Mar 11.

 

 

以下是更多的乳癌CTC文獻:

*無進展存活期 = PFS

*無病存活期 = DFS

*總存活期 = OS 

References

  1. A. Lucci et al., Circulating tumour cells in non-metastatic breast cancer: a prospective study. The Lancet. Oncology 13, 688-695 (2012).

  2. B. Rack et al., Circulating tumor cells predict survival in early average-to-high risk breast cancer patients. Journal of the National Cancer Institute 106, (2014).

  3. W. J. Janni et al., Pooled Analysis of the Prognostic Relevance of Circulating Tumor Cells in Primary Breast Cancer. Clinical cancer research : an official journal of the American Association for Cancer Research 22, 2583-2593 (2016).

  4. L. Zhang et al., Meta-analysis of the prognostic value of circulating tumor cells in breast cancer. Clinical cancer research : an official journal of the American Association for Cancer Research 18, 5701-5710 (2012).

  5. M. Giuliano et al., Circulating tumor cells as early predictors of metastatic spread in breast cancer patients with limited metastatic dissemination. Breast cancer research : BCR 16, 440 (2014).

  6. D. F. Hayes et al., Circulating tumor cells at each follow-up time point during therapy of metastatic breast cancer patients predict progression-free and overall survival. Clinical cancer research : an official journal of the American Association for Cancer Research 12, 4218-4224 (2006).

  7. M. Wallwiener et al., Serial enumeration of circulating tumor cells predicts treatment response and prognosis in metastatic breast cancer: a prospective study in 393 patients. BMC cancer 14, 512 (2014).

  8. U. De Giorgi et al., Circulating tumor cells and bone metastases as detected by FDG-PET/CT in patients with metastatic breast cancer. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO 21, 33-39 (2010).

  9. M. Bulfoni et al., In patients with metastatic breast cancer the identification of circulating tumor cells in epithelial-to-mesenchymal transition is associated with a poor prognosis. Breast cancer research : BCR 18, 30 (2016).

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