Evolution of estrogen receptor status from primary tumors to metastasis and serially collected circulating tumor cells

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@article{d76f9da48b7a43988bb10c9150df51a5,
title = "Evolution of estrogen receptor status from primary tumors to metastasis and serially collected circulating tumor cells",
abstract = "Background: The estrogen receptor (ER) can change expression between primary tumor (PT) and distant metastasis (DM) in breast cancer. A tissue biopsy reflects a momentary state at one location, whereas circulating tumor cells (CTCs) reflect real-time tumor progression. We evaluated ER-status during tumor progression from PT to DM and CTCs, and related the ER-status of CTCs to prognosis. Methods: In a study of metastatic breast cancer, blood was collected at different timepoints. After CellSearch{\textregistered} enrichment, CTCs were captured on DropMount slides and evaluated for ER expression at baseline (BL) and after 1 and 3 months of therapy. Comparison of the ER-status of PT, DM, and CTCs at different timepoints was performed using the McNemar test. The primary endpoint was progression-free survival (PFS). Results: Evidence of a shift from ER positivity to negativity between PT and DM was demonstrated (p = 0.019). We found strong evidence of similar shifts from PT to CTCs at different timepoints (p <0.0001). ER-positive CTCs at 1 and 3 months were related to better prognosis. Conclusions: A shift in ER-status from PT to DM/CTCs was demonstrated. ER-positive CTCs during systemic therapy might reflect the retention of a favorable phenotype that still responds to therapy.",
keywords = "Breast cancer, Circulating tumor cells, Estrogen receptor: Tumor progression, Metastasis",
author = "Carina Forsare and Bendahl, {P{\"a}r Ola} and Eric Moberg and J{\o}rgensen, {Charlotte Levin Tykj{\ae}r} and Sara Jansson and Larsson, {Anna Maria} and Kristina Aaltonen and Lisa Ryd{\'e}n",
year = "2020",
month = apr,
day = "2",
doi = "10.3390/ijms21082885",
language = "English",
volume = "21",
journal = "International Journal of Molecular Sciences",
issn = "1422-0067",
publisher = "MDPI AG",
number = "8",

}