Abstract

Background

Circulating tumor cells (CTCs) are associated with worse prognosis in metastatic breast cancer (BC). We evaluated the association of metabolic, inflammatory, and tumor markers with CTCs in women with metastatic BC before commencing a new systemic therapy.

Methods

Ninety-six patients with newly diagnosed or progressing metastatic BC without current diabetes or use of anti-inflammatory agents were recruited from four Ontario hospitals. Women provided fasting blood for measurement of metabolic, inflammatory, and tumor markers and CTCs. CTCs were assayed within 72 hours of collection using CellSearch. Other blood was frozen at –80°C, and assays were performed in a single batch. Associations between CTC counts with study factors were evaluated using Spearman correlation, and the chi-square or Fisher exact test. All statistical tests were two-sided and P value ≤ .05 was considered statistically significant.

Results

The median age was 60.5 years; 90.6% were postmenopausal. The cohort included hormone receptor–positive (87.5%), HER2–positive (15.6%), and triple-negative (10.4%) BCs. Patients were starting firstline (35.5%), second-line (26.0%), or third-or-later-line therapy (38.5%). CTC counts (per 7.5 mL of blood) ranged from 0 to 1238 (median 2); an elevated CTC count, defined as five or more CTCs, was detected in 42 (43.8%) patients. Those with liver metastases (vs not) more frequently had an elevated CTC count (59.0% vs 33.3%, P = .02). CTCs were significantly associated with C-reactive protein (R = .22, P = .02), interleukin (IL)-6 (R = .25, P = .01), IL-8 (R = .38, P = .0001), plasminogen activator inhibitor 1 (R = .31, P = .001), carcinoembryonic antigen (R = .31, P = .002), and cancer antigen 15-3 (R = .40, P = .0001) and inversely associated with body mass index (R = –.23, P = .02) and leptin (R = –.26, P = .01).

Conclusions

CTC counts were positively associated with tumor and inflammatory markers and inversely associated with some metabolic markers, potentially reflecting tumor burden and cachexia.

Details

Title
Association of Metabolic, Inflammatory, and Tumor Markers With Circulating Tumor Cells in Metastatic Breast Cancer
Author
Lohmann, Ana Elisa 1 ; Dowling, Ryan J O 2 ; Ennis, Marguerite 3 ; Amir, Eitan 4 ; Elser, Christine 5 ; Brezden-Masley, Christine 6 ; Vandenberg, Theodore 7 ; Lee, Elma 8 ; Fazaee, Kamran 8 ; Stambolic, Vuk 9 ; Goodwin, Pamela J 1 ; Chang, Martin C 10 

 Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Sinai Health System; Department of Medicine, University of Toronto, Toronto, ON, Canada 
 University Health Network, Princess Margaret Cancer Centre, Toronto, ON, Canada 
 Applied Statistician, Markham, ON, Canada 
 Department of Medicine, University of Toronto, Toronto, ON, Canada; University Health Network, Princess Margaret Cancer Centre, Toronto, ON, Canada 
 Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Sinai Health System; Department of Medicine, University of Toronto, Toronto, ON, Canada; University Health Network, Princess Margaret Cancer Centre, Toronto, ON, Canada 
 Department of Medicine, University of Toronto, Toronto, ON, Canada; St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada 
 London Regional Cancer Program, London, ON, Canada 
 Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Sinai Health System 
 Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada; University Health Network, Princess Margaret Cancer Centre, Toronto, ON, Canada 
10  Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Sinai Health System; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada 
Publication year
2018
Publication date
Apr 2018
Publisher
Oxford University Press
e-ISSN
25155091
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3170500859
Copyright
© The Author(s) 2018. Published by Oxford University Press. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.