Unbiased quantitative assessment of HER-2 expression on circulating tumor cells in patients with metastatic and non-metastatic breast cancer.

Sjoerd Ligthart, F.-C. Bidard, C. Decraene, S. Delaloge, E. Brain, M. Campone, J.Y. Pierga, Leonardus Wendelinus Mathias Marie Terstappen

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53 Citations (Scopus)

Abstract

Background: Circulating tumor cells (CTCs) can provide the basis for a liquid biopsy and may guide the use of targeted therapies. We report on unbiased quantification of Her-2 protein expression of CTCs.

Patients and methods: Her-2 assessment of CTCs was carried out using the CellSearch® system in 103 metastatic (M1) and 88 non-metastatic (M0) breast-cancer patients. Expression of Her-2 on CTCs was determined by a manual review and an automated algorithm using Her-2- fluorescein isothiocyanate (FITC) fluorescence of leukocytes to determine the Her-2-expression threshold in each sample.

Results: Her-2 expression of CTCs varied greatly within and among patients compared with Her-2 expression of leukocytes. In M1 patients, a threshold of 75% of Her-2 positive CTCs in patients with ≥5 CTCs was set. Applying this threshold, 9% of M1 patients with Her-2-negative primary tumors had Her-2-positive CTC status and 29% of M1 patients with Her-2-positive primary tumors had Her-2-negative CTC status. No Her-2 discrepancy was observed between CTCs and primary tumors in M0 patients.

Conclusions: Our findings demonstrate that Her-2 expression is heterogeneous among CTCs within each patient. We show the feasibility of unbiased quantitative and reproducible assessment of treatment targets on CTCs, opening a path towards personalized treatment
Original languageEnglish
Pages (from-to)1231-1238
Number of pages8
JournalAnnals of oncology
Volume24
Issue number5
DOIs
Publication statusPublished - 27 Dec 2013

Keywords

  • IR-82813
  • METIS-289283

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