Evidence map›Paper›PMID 34839105›Full record

ArticleESMO open2021

Prognostic relevance of the HER2 status of circulating tumor cells in metastatic breast cancer patients screened for participation in the DETECT study program.

V Müller, M Banys-Paluchowski, T W P Friedl, P A Fasching, A Schneeweiss, A Hartkopf, D Wallwiener, B Rack, F Meier-Stiegen, J Huober and 11 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESMO open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed
3.8field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 52 citations in OpenAlex.

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  12. Role of circulating tumor cells in breast cancer.Breast cancer (Tokyo, Japan) · 2025
    Review
  13. Review
  14. Article
  15. Personalized treatment approach for HER2-positive metastatic breast cancer.Medical oncology (Northwood, London, England) · 2024
    Review
  16. Review
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  18. Review
  19. Article
  20. Clinical application of circulating tumor cells.Medizinische Genetik : Mitteilungsblatt des Berufsverbandes Medizinische Genetik e.V · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 13 institutions in 1 country.

V MüllerDepartment of Gynecology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. Electronic address: v.mueller@uke.de.
M Banys-PaluchowskiGynecology and Obstetrics Department, University of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany; Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany.
T W P FriedlDepartment of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany.
P A FaschingDepartment of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.
A SchneeweissDivision Gynecologic Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital and German Cancer Research Center, Heidelberg, Germany.
A HartkopfDepartment of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany.
D WallwienerDepartment of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany.
B RackDepartment of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany.
F Meier-StiegenDepartment of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany.
J HuoberDepartment of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany.
M RübnerDepartment of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.
O HoffmannDepartment of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany.
L MüllerOnkologieUnterEms, Leer, Germany.
W JanniDepartment of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany.
P WimbergerDepartment of Gynecology and Obstetrics, University Hospital Carl Gustav Carus Dresden, TU Dresden, Germany; National Center for Tumor Diseases (NCT), Dresden, Germany.
B JägerDepartment of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany.
K PantelInstitute of Tumor Biology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
S RiethdorfInstitute of Tumor Biology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
N HarbeckBreast Center, Department of Gynecology and Obstetrics and CCC Munich, LMU University Hospital, Munich, Germany.
T FehmDepartment of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany.
DETECT study group
University Hospital Ulm · DEHeinrich Heine University Düsseldorf · DEUniversity Children's Hospital Tübingen · DEUniversity Medical Center Hamburg-Eppendorf · DEComprehensive Cancer Center Erlangen · DEDüsseldorf University Hospital · DEEssen University Hospital · DELMU Klinikum · DENational Center for Tumor Diseases · DETU Dresden · DEUniversität Hamburg · DEUniversitätsklinikum Erlangen · DEUniversity of Lübeck · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCirculating tumor cells (CTCs) have been reported to predict clinical outcome in metastatic breast cancer (MBC). Biology of CTCs may differ from that of the primary tumor and HER2-positive CTCs are found in some patients with HER2-negative tumors. PATIENTS AND

methodsPatients with HER2-negative MBC were screened for participation in DETECT III and IV trials before the initiation of a new line of therapy. Blood samples were analyzed using CELLSEARCH. CTCs were labeled with an anti-HER2 antibody and classified according to staining intensity (negative, weak, moderate, or strong staining).

resultsScreening blood samples were analyzed in 1933 patients with HER2-negative MBC. As many as 1217 out of the 1933 screened patients (63.0%) had ≥1 CTC per 7.5 ml blood; ≥5 CTCs were detected in 735 patients (38.0%; range 1-35 078 CTCs, median 8 CTCs). HER2 status of CTCs was assessed in 1159 CTC-positive patients; ≥1 CTC with strong HER2 staining was found in 174 (15.0%) patients. The proportion of CTCs with strong HER2 staining among all CTCs of an individual patient ranged between 0.06% and 100% (mean 15.8%). Patients with estrogen receptor (ER)- and progesterone receptor (PR)-positive tumors were more likely to harbor ≥1 CTC with strong HER2 staining. CTC status was significantly associated with overall survival (OS). Detection of ≥1 CTC with strong HER2 staining was associated with shorter OS [9.7 (7.1-12.3) versus 16.5 (14.9-18.1) months in patients with CTCs with negative-to-moderate HER2 staining only, P = 0.013]. In multivariate analysis, age, ER status, PR status, Eastern Cooperative Oncology Group performance status, therapy line, and CTC status independently predicted OS.

conclusionCTC detection in patients with HER2-negative disease is a strong prognostic factor. Presence of ≥1 CTC with strong HER2 staining was associated with shorter OS, supporting a biological role of HER2 expression on CTCs.

Indexed as

Breast NeoplasmsNeoplastic Cells, CirculatingBiomarkers, TumorErb-b2 Receptor Tyrosine KinasesFemaleHumansPrognosisBiomarkers, TumorErb-b2 Receptor Tyrosine Kinasesbreast cancercirculating tumor cellHER2 statusliquid biopsysurvival

Identifiers

PMID34839105
PMCPMC8637493
OpenAlexW3215745894

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.