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Baseline circulating stem-like cells predict survival in patients with metastatic breast Cancer
BACKGROUND: Circulating tumor cells (CTCs) are associated with breast cancer prognosis. Research is limited regarding the role of circulating cancer stem-like cells (cCSCs) considering the treatment response and survival among patients with metastatic breast cancer. Accordingly, we performed this pr...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889331/ https://www.ncbi.nlm.nih.gov/pubmed/31791269 http://dx.doi.org/10.1186/s12885-019-6370-1 |
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author | Lee, Chun-Hui Hsieh, Jason Chia-Hsun Wu, Tyler Min-Hsien Yeh, Ting-Shiuan Wang, Hung-Ming Lin, Yung-Chan Chen, Jen-Shi Lee, Chia-Lin Huang, Wen-Kuan Hung, Tsung-Min Yen, Tzu-Tsen Chan, Sheng-Chieh Chou, Wen-Chi Kuan, Feng-Che Hu, Ching-Chih Chang, Pei-Hung |
author_facet | Lee, Chun-Hui Hsieh, Jason Chia-Hsun Wu, Tyler Min-Hsien Yeh, Ting-Shiuan Wang, Hung-Ming Lin, Yung-Chan Chen, Jen-Shi Lee, Chia-Lin Huang, Wen-Kuan Hung, Tsung-Min Yen, Tzu-Tsen Chan, Sheng-Chieh Chou, Wen-Chi Kuan, Feng-Che Hu, Ching-Chih Chang, Pei-Hung |
author_sort | Lee, Chun-Hui |
collection | PubMed |
description | BACKGROUND: Circulating tumor cells (CTCs) are associated with breast cancer prognosis. Research is limited regarding the role of circulating cancer stem-like cells (cCSCs) considering the treatment response and survival among patients with metastatic breast cancer. Accordingly, we performed this prospective study to clarify the prognostic significance of baseline cCSCs for metastatic breast cancer in terms of first-line chemotherapy. METHODS: Between April 2014 and January 2016, we prospectively enrolled 48 patients with stage IV breast invasive ductal carcinoma who underwent first-line chemotherapy. We identified and analyzed CTCs and cCSCs by using a protocol based on negative selection and flow cytometry before chemotherapy. CTCs were identified as EpCAM(+)Hoechst(+)CD45(–) cells and cCSCs as CD133(+)EpCAM(+)Hoechst(+)CD45(–) cells. cCSCs were expressed as a percentage of CTCs. The associations between CTCs, cCSCs, and the clinicopathological variables that were predictive of the treatment response and survival outcome were analyzed using univariate and multivariate analyses. RESULTS: We identified CTCs in all the enrolled patients, with a median number of 33.9/mL CTCs. CSCs were isolated in 97.9% of the patients; the median percentage of cCSCs was 14.7%. A high baseline level of cCSCs was correlated with an inferior tumor response rate (54.2% vs. 95.8%, p < 0.001), overall survival (OS; median: 27.7 months vs. not reached, p < 0.001), and progression-free survival (PFS; median: 5.7 vs. 18.0 months, p < 0.001). Multivariate analysis revealed that along with other clinical variables, baseline cCSCs remained an independent prognostic factor for OS and PFS. CONCLUSIONS: Baseline cCSCs predict the treatment response as well as survival in patients with metastatic breast cancer undergoing first-line chemotherapy. Therefore, the measurement of cCSCs may assist in identifying early cancer treatment response and prognosis. |
format | Online Article Text |
id | pubmed-6889331 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-68893312019-12-11 Baseline circulating stem-like cells predict survival in patients with metastatic breast Cancer Lee, Chun-Hui Hsieh, Jason Chia-Hsun Wu, Tyler Min-Hsien Yeh, Ting-Shiuan Wang, Hung-Ming Lin, Yung-Chan Chen, Jen-Shi Lee, Chia-Lin Huang, Wen-Kuan Hung, Tsung-Min Yen, Tzu-Tsen Chan, Sheng-Chieh Chou, Wen-Chi Kuan, Feng-Che Hu, Ching-Chih Chang, Pei-Hung BMC Cancer Research Article BACKGROUND: Circulating tumor cells (CTCs) are associated with breast cancer prognosis. Research is limited regarding the role of circulating cancer stem-like cells (cCSCs) considering the treatment response and survival among patients with metastatic breast cancer. Accordingly, we performed this prospective study to clarify the prognostic significance of baseline cCSCs for metastatic breast cancer in terms of first-line chemotherapy. METHODS: Between April 2014 and January 2016, we prospectively enrolled 48 patients with stage IV breast invasive ductal carcinoma who underwent first-line chemotherapy. We identified and analyzed CTCs and cCSCs by using a protocol based on negative selection and flow cytometry before chemotherapy. CTCs were identified as EpCAM(+)Hoechst(+)CD45(–) cells and cCSCs as CD133(+)EpCAM(+)Hoechst(+)CD45(–) cells. cCSCs were expressed as a percentage of CTCs. The associations between CTCs, cCSCs, and the clinicopathological variables that were predictive of the treatment response and survival outcome were analyzed using univariate and multivariate analyses. RESULTS: We identified CTCs in all the enrolled patients, with a median number of 33.9/mL CTCs. CSCs were isolated in 97.9% of the patients; the median percentage of cCSCs was 14.7%. A high baseline level of cCSCs was correlated with an inferior tumor response rate (54.2% vs. 95.8%, p < 0.001), overall survival (OS; median: 27.7 months vs. not reached, p < 0.001), and progression-free survival (PFS; median: 5.7 vs. 18.0 months, p < 0.001). Multivariate analysis revealed that along with other clinical variables, baseline cCSCs remained an independent prognostic factor for OS and PFS. CONCLUSIONS: Baseline cCSCs predict the treatment response as well as survival in patients with metastatic breast cancer undergoing first-line chemotherapy. Therefore, the measurement of cCSCs may assist in identifying early cancer treatment response and prognosis. BioMed Central 2019-12-02 /pmc/articles/PMC6889331/ /pubmed/31791269 http://dx.doi.org/10.1186/s12885-019-6370-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Lee, Chun-Hui Hsieh, Jason Chia-Hsun Wu, Tyler Min-Hsien Yeh, Ting-Shiuan Wang, Hung-Ming Lin, Yung-Chan Chen, Jen-Shi Lee, Chia-Lin Huang, Wen-Kuan Hung, Tsung-Min Yen, Tzu-Tsen Chan, Sheng-Chieh Chou, Wen-Chi Kuan, Feng-Che Hu, Ching-Chih Chang, Pei-Hung Baseline circulating stem-like cells predict survival in patients with metastatic breast Cancer |
title | Baseline circulating stem-like cells predict survival in patients with metastatic breast Cancer |
title_full | Baseline circulating stem-like cells predict survival in patients with metastatic breast Cancer |
title_fullStr | Baseline circulating stem-like cells predict survival in patients with metastatic breast Cancer |
title_full_unstemmed | Baseline circulating stem-like cells predict survival in patients with metastatic breast Cancer |
title_short | Baseline circulating stem-like cells predict survival in patients with metastatic breast Cancer |
title_sort | baseline circulating stem-like cells predict survival in patients with metastatic breast cancer |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889331/ https://www.ncbi.nlm.nih.gov/pubmed/31791269 http://dx.doi.org/10.1186/s12885-019-6370-1 |
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