Br J Cancer:CirCe01 randomized trial analyzes the clinical usefulness of chemotherapy surveillance strategies based on circulating tumor cells in patients with metastasis breast cancer

Metastasis breast cancer (MBC) is one of the leading causes of cancer death in women worldwide.
As noted at the High Level Breast Cancer Consensus Conference, MBC is an incurable but treatable disease with an average total survival of 5 years in the HER2-positive (HER2-plus) and estrogen-positive (ER-plus) subgroups.
patients may be accompanied by chemotherapy resistance after receiving first-line chemotherapy.
Although the current use of eribulin as a second- or third-line chemotherapy drug has shown significant statistical improvements in overall survival rates, the survival benefits of subsequent later chemotherapy remain debated.
clinical features or clinical markers are currently available to determine whether patients with advanced chemotherapy benefit.
Circulating Tumor Cell (CTC) is a rare tumor cell that can be detected in outer blood.
published a study of 177 MPC patients as early as 2004 and proposed a distinction between MPC patients.
based on relevant clinical effectiveness data.
changes in CTC counting have been identified as a prognostic marker for patients, and previous studies have confirmed the effectiveness of CTC counts.
The CirCe01 trial was designed in this study, the researchers reported the results of the CirCe01 trial, a forward-looking CTC-based trial designed to assess the clinical usefulness of CTC-based monitoring for MPC patients after third-line chemotherapy (LC).
CirCe01 is a forward-looking, multi-center randomized trial (NCT01349842) that includes two systematic post-LC CTC monitoring ≥5 CTC/7.5 mL MPC patients.
patients were randomly divided into CTC drive groups and standard groups.
in the CTC group, changes in the CTC count are evaluated at the first cycle of each LC course.
early progression of tumors predicted by CTC levels will change subsequent LC treatment strategies.
5 CTC/7.5 mL was observed in 101 patients out of≥ a total of 204 patients with a survival curve of 204 patients.
In the CTC group (N-51), 43 (83%) and 18 (44%) patients completed CTC monitoring in third- and fourth-line treatments, of which 18 (42%) and 11 (61%) patients did not respond to CTC, respectively.
in these patients, 13 (72%) and 5 (46%) patients, respectively, experienced early progress of the disease and switched to the next LC treatment.
further studies showed no significant difference in overall survival rates between the two groups.
subgroup analysis showed that patients who did not have a CTC response and switched to chemotherapy had a longer lifesaly period than those who did not receive chemotherapy.
, the study was designed to assess whether chemotherapy programmes that repeated CTC tests could provide significant survival benefits.
the clinical ability of CTC monitoring due to problems such as accrual and drug compliance.