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

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift


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® 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.


Enheter & grupper
Externa organisationer
  • Skåne University Hospital

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Cancer och onkologi


TidskriftInternational Journal of Molecular Sciences
Utgåva nummer8
StatusPublished - 2020 apr 2
Peer review utfördJa