文章来源：CSCO
2014年美国临床肿瘤学会年会将于当地时间5月30日-6月3日在芝加哥召开，根据大会的会议日程，我国肿瘤专家江泽飞教授在6月2日上午有一项研究在“General Poster Session”中展出，下面和大家提前分享这项精彩研究。医脉通小编们今年也将继续奔赴ASCO年会现场，及时将各项最新研究进展整理、发布，欢迎大家保持关注！
循环肿瘤细胞（CTCs）计数的价值已被广泛接受，但CTCs计数的预测价值与HER-2表达检测（CTCS-HER2）在接受HER-2靶向治疗的HER2阳性疾病患者中仍然没有得到前瞻性证实。
研究方法
2010年10月至2013年11月，共招募了101例 HER-2阳性（ IHC HER2 + + +或FISH +）患者。所有患者接受化疗加曲妥珠单抗或拉帕替尼治疗。 使用CellSearch技术进行CTC分离，计数并描述其特征。根据既往试验，CTC 中的HER2表达强度分为0，1+，2+或3+分，CTC HER2阳性标准定义为HER2 （3 +）过表达CTC > 30％。激素受体阳性（HR +）定义为ER或PR阳性，激素受体阴性（ HR- ）定义为ER或PR阴性。
研究结果
101例患者中，56例（55.4％）CTC ≥ 1，其中 29例（51.8％）患者CTCHER2阳性，27例（48.2％）为CTCHER2阴性。CTCHER2阳性组和CTCHER2阴性组间的PFS有统计学差异（P=0.014）。CTC≥ 5的患者中，HR-患者的PFS优于HR +患者（7个月：4个月）。CTCHER2阳性和激素受体阴性患者的PFS为8.5个月，CTCHER2阴性和激素受体阳性患者则为2.5个月（P=0.003）。
结论
这项分析表明，接受化疗加抗HER2治疗的不同HR状态下HER2阳性转移性乳腺癌患者的基线CTC计数缺乏预测价值，但基线CTCHER2状态检测则可明显预测疗效。此外，化疗加抗HER2治疗对CTCHER2阳性和HR-患者益处最大。患者进行分子靶向治疗前应前瞻性进行常规CTCs生物标志物评估。
医脉通整理报道，转载请注明出处。
会议专题》》》2014年ASCO年会专题报道
阅读英文摘要
Predictive value of CTCs biomarkers status in patients with metastatic breast cancer (MBC) receiving anti-HER2 therapy.(Abstract No:628)
Authors: Zefei Jiang, Lei Li, Shaohua Zhang, Tao Wang, et al.
Session Type: General Poster Session
Background: The value of circulating tumor cells (CTCs) enumeration has been widely accepted, but the predictive value of enumeration and the detection of HER-2 expression in CTCs (CTCs-HER2) in patients with HER2 positive disease treated with HER-2 targeted therapy has still not been prospectively demonstrated.
Methods: One hundred one HER-2 positive (IHC HER2+++ or FISH+) patients were enrolled from Oct 2010 to Nov 2013. All of the patients received a new line of treatment with chemotherapy plus trastuzumab or lapatinib. CTC isolation, enumeration and characterization were performed by using the CellSearch technology. HER2 expression intensity in CTC was given a score of 0, 1+, 2+, or 3+, according to the trial we have conducted previously, the CTCHER2 positive criterion was defined as >30% of CTCs over-expressing HER2 (3+). Hormone receptor positive(HR+) was defined as ER or PR positive and hormone receptor negative(HR-) was defined as ER or PR negative.
Results: 56(55.4%) out of 101 patients were detected with CTC≥1. For the patients who detected CTC, 29(51.8%) patients were CTCHER2-positive, 27(48.2%) were CTCHER2-negative. There was a statistically difference in PFS between the groups of CTCHER2-positive and the CTCHER2-negative (P=0.014). For the patients with ≥5 CTC, HR- patients benefit a longer PFS compared with HR+ patients (7m vs 4m). The PFS for CTCHER2-positive and hormone receptor negative patients versus CTCHER2- negative and hormone receptor positive patients were 8.5 months versus 2.5 months(P=0.003).
Conclusions: This analysis demonstrates that the baseline enumeration of CTC for HER2 positive MBC patients with different HR statuses who received chemo plus anti-HER2 therapy lacks of predictive value, whereas the detection of baseline CTCHER2 status is associated with significant prediction of therapeutic benefit. Moreover, the CTCHER2 positive and HR- patients can benefit most from chemo plus anti-HER2 therapy. Routine CTCs biomarkers assessment should be prospectively evaluated in patients candidates for molecularly targeted therapies.