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

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

Abstract:

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 performed.

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.

Results: 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.