The prognostic value of HER2-positive circulating tumor cells in breast cancer patients: a systematic review and meta-analysis

• Published in: Clinical breast cancer Vol. 17; no. 5; pp. 341 - 349
• Main Authors: Wang, Cheng-Hsu, MD, Chang, Chee-Jen, PhD, Yeh, Kun-Yun, MD, PhD, Chang, Pei-Hung, MD, Huang, Jen-Seng, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2017
• Subjects: Biomarkers, Tumor - blood; Breast Neoplasms - blood; Breast Neoplasms - pathology; Female; Hematology, Oncology and Palliative Medicine; Humans; Metastatic breast cancer; Neoplastic Cells, Circulating - pathology; Non-metastatic breast cancer; Obstetrics and Gynecology; Prognosis; Progression-free survival; Receptor, ErbB-2 - blood; Survival; Therapy resistance; meta-analysis; Breast cancer; circulating tumor cells; HER2; survival; Non-metastatic breast cancer; Metastatic breast cancer; Therapy resistance; Progression-free survival; Survival
• ISSN: 1526-8209; 1938-0666
• DOI: 10.1016/j.clbc.2017.02.002

Abstract Introduction A meta-analysis was conducted to determine the prognostic value of human epidermal growth receptor (HER)2-positive circulating tumor cells (CTCs) in patients with breast cancer. Materials and methods Medline, Central, and Embase databases were search. Inclusion criteria were: 1) Randomized controlled trials (RCTs), 2-arm prospective studies, and retrospective studies; 2) Patients with breast cancer; 3) HER2-positive CTCs were examined; 4) Hazard ratio of survival between patients with HER2-positive and HER2-negative CTCs was reported. Results Four studies with a total of 550 patients with stage I-IV breast cancer were included. HER2-positive CTCs were not associated with worse overall survival (OS) (hazard ratio [HR] = 1.489, 95% CI: 0.873-2.540, P = .144) or progression-free survival (PFS) (HR = 1.543, 95% CI: 0.636-3.744, P = .338). In patients without metastasis, Her2-positive CTCs were associated with worse OS (HR: 2.273, 95% CI: 1.340-3.853, P = .002) and worse PFS (HR = 2.870, 95% CI: 1.298-6.343, P = .009). There is no significant relationship between HER2-positive CTCs and survival in subgroup of patients with metastasis. Conclusion HER2-positive CTCs have prognostic value in patients with breast cancer and without distant metastasis.