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

Forsare, Carina LU orcid ; Bendahl, Pär Ola LU ; Moberg, Eric LU ; Jørgensen, Charlotte Levin Tykjær LU ; Jansson, Sara LU ; Larsson, Anna Maria LU ; Aaltonen, Kristina LU orcid and Rydén, Lisa LU orcid (2020) In International Journal of Molecular Sciences 21(8).
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® 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... (More)

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.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast cancer, Circulating tumor cells, Estrogen receptor: Tumor progression, Metastasis
in
International Journal of Molecular Sciences
volume
21
issue
8
article number
2885
publisher
MDPI AG
external identifiers
  • pmid:32326116
  • scopus:85083994840
ISSN
1661-6596
DOI
10.3390/ijms21082885
language
English
LU publication?
yes
id
d76f9da4-8b7a-4398-8bb1-0c9150df51a5
date added to LUP
2020-05-20 13:00:56
date last changed
2025-10-14 11:40:52
@article{d76f9da4-8b7a-4398-8bb1-0c9150df51a5,
  abstract     = {{<p>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 &lt;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.</p>}},
  author       = {{Forsare, Carina and Bendahl, Pär Ola and Moberg, Eric and Jørgensen, Charlotte Levin Tykjær and Jansson, Sara and Larsson, Anna Maria and Aaltonen, Kristina and Rydén, Lisa}},
  issn         = {{1661-6596}},
  keywords     = {{Breast cancer; Circulating tumor cells; Estrogen receptor: Tumor progression; Metastasis}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{8}},
  publisher    = {{MDPI AG}},
  series       = {{International Journal of Molecular Sciences}},
  title        = {{Evolution of estrogen receptor status from primary tumors to metastasis and serially collected circulating tumor cells}},
  url          = {{http://dx.doi.org/10.3390/ijms21082885}},
  doi          = {{10.3390/ijms21082885}},
  volume       = {{21}},
  year         = {{2020}},
}