Background: The estrogen receptor (ER) can change expression between primary tumor (PT) and distant metastasis (DM) in breast cancer

Background: The estrogen receptor (ER) can change expression between primary tumor (PT) and distant metastasis (DM) in breast cancer. timepoints was performed using the McNemar test. The primary endpoint was progression-free survival (PFS). Results: Evidence of a shift from ER positivity to negativity between PT and DM was exhibited (= 0.019). We found strong evidence of comparable shifts from PT to CTCs at different timepoints ( 0.0001). ER-positive CTCs at 1 and 3 months were related to better prognosis. Conclusions: A shift in ER-status from PT to DM/CTCs was exhibited. ER-positive CTCs during systemic therapy might reflect the retention of a favorable phenotype that still responds to therapy. = 147), the median age was 65 years (range 40C84 years; Physique 1, Table 1). In total, 63% (92/147) of the patients were given endocrine therapy as first-line systemic therapy, whereas 48% (70/147) had chemotherapy. Furthermore, 84% (123/147) of PTs and 86% (105/122) of DMs were ER-positive (Table 1). The median time from diagnosis of PT to diagnosis of MBC was five years (range 0C36 years). Lentinan Open in a separate window Physique 1 Flowchart of study cohort. CTC = circulating tumor cell, ER = estrogen receptor. Table 1 Patient and tumor characteristics for = 147 with an available estrogen receptor (ER) status in the primary tumor (PT). CTC = circulating tumor cell, BL = baseline, DM = distant metastases, MBC = metastatic breast cancer, HER2 = human epidermal growth factor receptor 2, NHG = Nottingham histological grade. = 147)= 113)= 60)= 46)= 122)(%) Unfavorable24 (16%)17 (15%)8 (13%)6 (13%)17 (14%)Positive123 (84%)93 (85%)52 (87%)40 (87%)105 (86%)Missing 3 1 DM ER-status, (%) Unfavorable28 (23%)22 (23%)13 (25%)7 (18%)28 (23%)Positive94 (77%)73 (77%)39 (75%)31 (82%)94 (77%)Missing25188825 HER2-status, (%) Lentinan Unfavorable109 (87%)83 (87%)50 (94%)39 (97%)88 (86%)Positive17 (13%)11 (13%)3 (6%)1 (3%)14 (14%)Missing21197620 PT tumor size, (%) T152 (37%)35 (34%)16 (27%)15 (35%)50 (42%)T249 (35%)37 (36%)23 (40%)14 (33%)43 (36%)T320 (14%)16 (16%)8 (14%)7 (16%)15 (13%)T419 (14%)15 (14%)11 (19%)7 (16%)10 (9%)Missing710234 PT Node status, (%) Node unfavorable41 (32%)27 (28%)13 (25%)10 (24%)39 (35%)Node positive88 (68%)72 (72%)39 (75%)30 (76%)74 (65%)Missing1814869 PT NHG, (%) Grade 112 (10%)8 (9%)2 (4%)4 (10%)11 (10%)Grade 264 (53%)52 (58%)31 (63%)24 (62%)60 (56%)Grade 345 (37%)29 (33%)16 (33%)11 (28%)37 (34%)Missing262411714 Ziconotide Acetate First-line systemic treatment, (%) Endocrine only92 (63%)67 (59%)35 (58%)33 (72%)86 (70%)Chemotherapy70 (48%)53 (47%)33 (53%)32 (70%)63 (52%)HER2-targeted5 (3%)1 (1%)1 (2%)1 (2%)5 (4%) CellSearch? BL CTC number Median (range)5 (0C2598)17 (0C2598)42 (0C2598)42 (0C2598)5 (0C2598)Mean6788811811974 Open in a separate window 2.1. CTC Status at Baseline and During Follow-Up At baseline (BL), 53% (76/144) of the patients were classified in the inferior prognostic group according to the previously approved and validated cut-off of 5 CTCs Lentinan [9,10]. The corresponding percentages after 1 and 3 months of the first-line of therapy were 29% (37/128) and 19% (21/113), respectively. DropMount slides could be prepared for 113 cases (Physique 1). When the CTC-DropMount method was used for CTC characterization, the corresponding numbers for cases included in the inferior prognostic group were 54% (35/65), 32% (7/22), and 52% (12/23) at BL, after 1 month and after 3 months of therapy, respectively. 2.2. ER Status of CTCs By again applying the CTC-DropMount method for characterization, 26% (17/65) of CTCs were ER-positive at BL compared with 23% (5/22) after 1 month and 43% (10/23) after 3 months of therapy. The distribution of number of CTCs at BL and the ER-status are depicted in Physique 2a, b. For ER-positive CTC situations at BL (Body 2a), the real amount of discovered cells ranged from 1 to 47, where cases had been regarded ER-positive if one or more CTC was positive for ER. Using a cut-off of 5CTCs, 13 situations could have been thought to be ER-positive at BL of 17 instead. For ER-negative situations (Body 2b), the real amount of evaluated CTCs varied from 1 to 1094. Open in another window Body 2 ER-status of CTCs. Depicted are Lentinan amount of examined circulating tumor cells (CTCs) for specific situations at baseline (BL) as well as the matching estrogen receptor (ER) distribution one of the.