Correlation of circulating or disseminated tumor cells with the Oncotype DX Recurrence Score
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PRECLINICAL STUDY
Correlation of circulating or disseminated tumor cells with the Oncotype DX Recurrence Score Puneet Singh1 · Sarah E. Tevis1,2 · Carolyn S. Hall1 · Salyna Meas1 · Rosa F. Hwang1 · Anthony Lucci1 Received: 16 June 2020 / Accepted: 13 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose New biomarkers are emerging to predict recurrence risk in women with early-stage breast cancer. High Oncotype DX Recurrence Score® (RS) is associated with worse disease-free and overall survival. Similarly, circulating tumor cells (CTCs, blood) and disseminated tumor cells (DTCs, bone marrow) have prognostic value in breast cancer. We investigated the association between high RS and CTCs or DTCs. Methods Using a prospective database, we evaluated patients with hormone receptor-positive/HER2-negative, node-negative invasive breast cancer from 1/2005 to 1/2017. RS was classified using TAILORx study cutoff points: low ( 25). CTCs were assessed using CellSearch® and DTCs using cytospin specimens of bone marrow aspirates. Positive result was defined as one or more CTCs or DTCs identified. Chi-square analyses were utilized to evaluate the relationship between RS and CTCs or DTCs. Results 233 patients were identified from a prospective database, of which 96 had RS results. Of these patients, 88 had CTC results and 58 had DTC results. CTCs were detected in 17/88 (19%) patients, while DTCs were detected in 20/58 (34%). Patients with high RS were not more likely to have CTCs (18%) compared to patients with low/intermediate RS (20%; p = 0.919). Similarly, high RS was not associated with DTC detection, with DTCs present in 40% of patients with high RS versus 33% with low/intermediate RS (p = 0.687). In the subgroup of patients ≤ 50 years, no associations were found between high RS and CTCs (p = 0.383) or DTCs (p = 0.234). Conclusions High Oncotype DX RS did not correlate with CTCs in blood or DTCs in bone marrow in our study. Keywords Circulating tumor cells · Disseminated tumor cells · Oncotype DX · 21-Gene recurrence score · Biomarker · Breast cancer
Background There has been increasing investigation of new and novel biomarkers that can predict the risk of recurrence in women with early-stage breast cancer. Oncotype DX RS is a 21-gene breast cancer assay that is commercially available and utilized in hormone receptor-positive breast cancer as a prognostic and predictive tool [1]. A high RS (≥ 31) has been found to be associated with worse disease-free and survival * Anthony Lucci [email protected] 1
Department of Breast Surgical Oncology, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
Present Address: Department of Surgery, University of Colorado, Aurora, CO, USA
2
overall in patients with early-stage breast cancer [1, 2]. Similarly, CTCs in the peripheral blood and DTCs in the bone marrow have prognostic value in patients with operable breast cancer, though these are not routinely used in clinical practice due to unproven predictive val
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