CELLSEARCH® Circulating Tumor Cell Test in metastatic breast cancer (mBC)—clinical trials and real-world case studies

Case Study 1

57-year-old patient with mBC showing increased circulating tumor cells (CTCs) after third line of therapy

Jeffrey Bubis, DO, Integrated Community Oncology Network, Jacksonville, FL

Patient history and response to treatment

  • Patient presented to the emergency department in May 2006; evaluation revealed mBC to her brain and bones
  • Patient was treated with whole brain radiation and 6 cycles of TAC (paclitaxel, doxorubicin, and carboplatin)
  • Patient was disease free for 6 months, after which progressive disease was noted in the liver
  • Patient received 3 cycles of capecitabine and achieved a complete response
  • Progressive disease (PD) was noted again after 6 cycles; gemcitabine was initiated
  • Patient was monitored monthly for CTC counts using the CELLSEARCH® CTC Test
  • Four months following initiation of gemcitabine therapy, CTCs were substantially elevated above the cutoff of ≥5 CTCs. Patient remained asymptomatic
  • A month later, CTCs were further elevated; PET/CT scan confirmed (PD) in the liver and lungs
  • Patient began new treatment with paclitaxel and achieved partial response with stable disease
Patient Longitudinal Graph
PD confirmed by PET/CT
The clinical cutoff of CTC per 7.5 mL of blood for mBC patients is ≥5

How CTCs helped inform the management of this patient

  • Sustained elevated CTCs, as determined by serial monitoring of this patient, prompted an early PET/CT scan
  • Confirmation of PD prompted an initiation of paclitaxel before clinical manifestation of progression
  • Patient achieved partial response with stable disease on the fourth line of therapy
  • As study results have indicated that a combination of CTC testing and radiological assessments provides the most accurate assessment of prognosis, their use helped in the clinical management of this patient1

CELLSEARCH® CTC Test results should be used in conjunction with all clinical information derived from diagnostic tests (eg, imaging or laboratory tests), physical examination and complete medical history, in accordance with appropriate management procedures.

This case study is for educational purposes only and does not constitute professional medical advice. The information provided in this case study should not be relied upon as the basis for making patient management decisions. This case study is not intended to show that any line of therapy is any more or less effective than any other or no therapy. Please see instructions for use for indications and limitations of the CELLSEARCH® CTC Test as a monitoring aid in management of metastatic breast, colorectal, and prostate cancer.

Reference: 
  1. CELLSEARCH® Circulating Tumor Cell Kit (Epithelial) Instructions for Use. Menarini Silicon Biosystems Inc.