内容紹介
Pretreatment and Posttreatment Evaluations of Circulating Tumor Cells(CTC)in Patients with Metastatic Breast Cancer
Summary
Recently, circulating tumor cells(CTCs)of cancer patients have been analyzed as a biomarker of disease progression and as a new prognostic tool. We conducted a pilot study to determine whether CTCs present before and after chemotherapy or peptide vaccination predicted outcome in patients with metastatic breast cancer(MBC). CTCs were isolated from the peripheral blood of MBC patients and evaluated using the CellSearch® System(Janssen Diagnostics). The expression of the HLA classⅠ molecule in the CTCs was analyzed simultaneously by using a flow cytometric system. A CTC-positive test result was defined as five or more CTCs/7.5 mL blood. Nine patients(median[range]age, 64.2 years[44-80 years])were included. Four(57.1%)of 7 MBC patients with Luminal A subtype tested positive for CTC. Of 6 MBC patients, 5(83.3%)had a decreased mean number of CTCs, from 35.8/7.5 to 0.4/7.5 mL, after 3 courses of systemic chemotherapy. Furthermore, CTC-HLA classⅠ expression level was decreased in 2(66.7%)of 3 patients after cytotoxic chemotherapy but increased in 4(80.0%)of 5 patients after 6 vaccinations with tumor-specific peptide vaccines. The number of CTCs and CTC-HLA classⅠ expression level in the patients with MBC changed after the treatment with systemic chemotherapy or peptide-vaccine therapy.
要旨
一般的に上皮性癌転移は血行性,リンパ行性,播種性に大別されるが,遠隔臓器への転移の主な要因は血行性転移である。末梢循環腫瘍細胞(circulating tumor cell: CTC)は血行性転移の主因と考えられている。CTC測定の有用性について検討した臨床試験では,転移再発乳癌においてCTC数が5個以上であった場合,予後不良であったと報告されており,CTC数を測定することは予後予測因子となる可能性が示唆された。今回われわれは,転移再発乳癌患者のCTC測定を行い,測定結果と患者背景について検討した。
目次
Summary
Recently, circulating tumor cells(CTCs)of cancer patients have been analyzed as a biomarker of disease progression and as a new prognostic tool. We conducted a pilot study to determine whether CTCs present before and after chemotherapy or peptide vaccination predicted outcome in patients with metastatic breast cancer(MBC). CTCs were isolated from the peripheral blood of MBC patients and evaluated using the CellSearch® System(Janssen Diagnostics). The expression of the HLA classⅠ molecule in the CTCs was analyzed simultaneously by using a flow cytometric system. A CTC-positive test result was defined as five or more CTCs/7.5 mL blood. Nine patients(median[range]age, 64.2 years[44-80 years])were included. Four(57.1%)of 7 MBC patients with Luminal A subtype tested positive for CTC. Of 6 MBC patients, 5(83.3%)had a decreased mean number of CTCs, from 35.8/7.5 to 0.4/7.5 mL, after 3 courses of systemic chemotherapy. Furthermore, CTC-HLA classⅠ expression level was decreased in 2(66.7%)of 3 patients after cytotoxic chemotherapy but increased in 4(80.0%)of 5 patients after 6 vaccinations with tumor-specific peptide vaccines. The number of CTCs and CTC-HLA classⅠ expression level in the patients with MBC changed after the treatment with systemic chemotherapy or peptide-vaccine therapy.
要旨
一般的に上皮性癌転移は血行性,リンパ行性,播種性に大別されるが,遠隔臓器への転移の主な要因は血行性転移である。末梢循環腫瘍細胞(circulating tumor cell: CTC)は血行性転移の主因と考えられている。CTC測定の有用性について検討した臨床試験では,転移再発乳癌においてCTC数が5個以上であった場合,予後不良であったと報告されており,CTC数を測定することは予後予測因子となる可能性が示唆された。今回われわれは,転移再発乳癌患者のCTC測定を行い,測定結果と患者背景について検討した。