CECs, CEPs and CTCs for prediction of response in patients with advanced breast cancer (ABC) receiving metronomic vinorelbine.

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Sub-category: Antiangiogenic or Antimetastatic Agents
Category: Developmental Therapeutics: Molecular Therapeutics
Meeting: 2009 ASCO Annual Meeting
Citation: J Clin Oncol 27, 2009 (suppl; abstr e14572)
Abstract No: e14572
Author(s): F. Nole,
E. Munzone, F. Bertolini, M. T. Sandri, G. Petralia, L. Adamoli, D.
Radice, D. Cullura, A. di Pietro, A. Goldhirsch; European Institute of
Oncology, Milan, Italy
Background: Metronomic administration of
chemotherapy given once or more per week with no extended gaps was
shown to be effectively anti-angiogenic, causing growth arrest or
apoptosis of endothelial cells in tumor neo-vessels. Preclinical and
clinical studies indicate that ultra-low concentrations of various
microtubule inhibitors inhibit proliferation or migration of
endothelial cells. We investigated in a phase II study the activity of
metronomic administration of oV in ABC, kinetics and response
prediction of CECs, CEPs, CTCs and of other biomarkers of angiogenesis
(soluble VEGF, VEGFr2, TSP1, bFGF). CT perfusion scans were also
Methods: From February 2008, 47 pts with
ABC received oV (50 mg/die TTW). Currently 20 pts are evaluable for
both activity and biomarker assessment. Baseline levels of biomarkers
of angiogenesis were correlated with clinical response.
Shown in attached Table.
Conclusions: We found that the
baseline value of apoptotic cells (expressed as % of total cells) was
significantly correlated with outcome. The baseline total, viable, and
apoptotic CEC count and CTCs might provide an indirect measure for
angiogenic turnover and an indicator of better response to
anti-angiogenic therapy, supporting the use of metronomic treatments in
patients expressing high levels of baseline CECs. Updated results will
be presented together with correlation with perfusion CT scan and
levels of CTCs.