Combined peripheral natural killer cell and circulating tumor cell enumeration enhance prognostic efficiency in patients with metastatic triple-negative breast cancer

摘要

Objective:Triple-negative breast cancer(TNBC)is a heterogeneous disease with poor prognosis.Circulating tumor cells(CTCs)are a promising predictor for breast cancer prognoses but their reliability regarding progression-free survival(PFS)is controversial.We aim to verify their predictive value in TNBC.Methods:In present prospective cohort study,we used the Pep@MNPs method to enumerate CTCs in baseline blood samples from 75 patients with TNBC(taken at inclusion in this study)and analyzed correlations between CTC numbers and outcomes and other clinical parameters.Results:Median PFS was 6.0(range:1.0–25.0)months for the entire cohort,in whom we found no correlations between baseline CTC status and initial tumor stage(P=0.167),tumor grade(P=0.783)or histological type(P=0.084).However,among those getting first-line treatment,baseline CTC status was positively correlated with ratio of peripheral natural killer(NK)cells(P=0.032),presence of lung metastasis(P=0.034)and number of visceral metastatic site(P=0.037).Baseline CTC status was predictive for PFS in first-line TNBC(P=0.033),but not for the cohort as a whole(P=0.118).This prognostic limitation of CTC could be ameliorated by combining CTC and NK cell enumeration(P=0.049).Conclusions:Baseline CTC status was predictive of lung metastasis,peripheral NK cell ratio and PFS in TNBC patients undergoing first-line treatment.We have developed a combined CTC-NK enumeration strategy that allows us to predict PFS in TNBC without any preconditions.