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Tumor heterogeneity and clinically invisible micrometastases in metastatic breast cancer-a call for enhanced surveillance strategies.
Bacon, Eliza R; Ihle, Kena; Guo, Weihua; Egelston, Colt A; Simons, Diana L; Wei, Christina; Tumyan, Lusine; Schmolze, Daniel; Lee, Peter P; Waisman, James R.
Afiliación
  • Bacon ER; The Center for Precision Medicine, City of Hope National Medical Center, Duarte, CA, USA. ebarragan@coh.org.
  • Ihle K; Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA. ebarragan@coh.org.
  • Guo W; The Center for Precision Medicine, City of Hope National Medical Center, Duarte, CA, USA.
  • Egelston CA; Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA.
  • Simons DL; Department of Immuno-Oncology, Beckman Research Institute at City of Hope, Duarte, CA, USA.
  • Wei C; Department of Immuno-Oncology, Beckman Research Institute at City of Hope, Duarte, CA, USA.
  • Tumyan L; Department of Immuno-Oncology, Beckman Research Institute at City of Hope, Duarte, CA, USA.
  • Schmolze D; Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA.
  • Lee PP; Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA, 91010, USA.
  • Waisman JR; Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA.
NPJ Precis Oncol ; 8(1): 81, 2024 Mar 29.
Article en En | MEDLINE | ID: mdl-38553598
ABSTRACT
The biology of metastatic breast cancer (MBC) is understudied, primarily due to the difficulty of procuring multiple samples from patients with oligometastatic breast cancer. We developed a rapid postmortem tissue procurement program that allows the collection and analysis of numerous metastatic lesions, subclinical locations, and potential pre-metastatic niches that fall within this scope. We conducted a rapid postmortem tissue collection study on 9 patients with MBC. Patients and their families consented to donate tissues immediately after death in an IRB-approved study. Various disease subtypes, progression histories, organ involvement, and final causes of death are reported. In patients with hormone receptor-positive (HR+) disease, estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki-67 expression were heterogeneous across metastatic lesions within individual patients. Disease phenotype at the end of life trended toward complete loss of HR expression. Nearly all (n = 7) patients exhibited extensive tumor involvement of additional organs that had not been previously diagnosed clinically and were not retrospectively visible on recent imaging. Of these seven individuals, three included organs uncommonly associated with MBC kidney, spleen, pancreas, and ovary. Finally, we identified clinically undetectable micrometastases in several organs uncommonly involved in MBC. Our findings raise several clinically relevant questions regarding the mechanisms of metastatic progression. Insights from this study argue for better surveillance strategies for monitoring MBC. We highlight the need to capture more accurate biomarker information in the context of heterogeneous disease and urge the consideration of treatment strategies that combine multiple targeted therapies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: NPJ Precis Oncol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: NPJ Precis Oncol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido