The lack of increases in circulating endothelial progenitor cell as a negative predictor for pathological response to neoadjuvant chemotherapy in breast cancer patients

Circulating endothelial progenitor cells are a potential surrogate marker for angiogenesis. Little is known about the alteration of circulating endothelial progenitor cell counts during neoadjuvant chemotherapy. Our goal was to reveal the alteration in CEP counts in association with response to neoadjuvant chemotherapy in patients with breast cancer. We measured the number of circulating endothelial progenitor cells (CD31(+)CD34(+)CD133(+)CD45(dim)) by four-color flow cytometry using blood samples from 57 patients with breast cancer who received neoadjuvant chemotherapy (5-fluorouracil + epirubicin + cyclophosphamide (FEC), docetaxel + cyclophosphamide (TC), cisplatin + docetaxel (TP)). There was no significant difference in the baseline circulating endothelial progenitor cell counts with respect to the clinical and pathological background factors. Circulating endothelial progenitor cell counts increased after the initiation of chemotherapy (pre-1st vs. pre-2nd cycle, p = 0.0035; pre-1st vs. pre-4th cycle, p = 0.047). An increase of circulating endothelial progenitor cell counts from pre-1st to pre-2nd cycle was associated with pCR (p = 0.013 for χ (2) test). A multivariate analysis, including subtype, and clinical response showed that the lack of circulating endothelial progenitor cell increases from pre-1st to pre-2nd cycle was an independent negative predictor of pCR (p = 0.002). Our data suggest that alterations in circulating endothelial progenitor cell counts are associated with treatment response. The circulating endothelial progenitor cell count could be a useful biomarker for monitoring chemotherapeutic response.