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@ARTICLE{Wimberger:274485,
author = {P. Wimberger$^*$ and J.-U. Blohmer and P. Krabisch and T.
Link$^*$ and M. Just and B. V. Sinn and E. Simon and C.
Solbach and T. Fehm and C. Denkert and C. Kühn and K. Rhiem
and H. Tesch and S. Kümmel and A. Petzold$^*$ and O.
Stötzer and C. Meisel$^*$ and J. D. Kuhlmann$^*$ and V.
Nekljudova and S. Loibl},
title = {{T}he effect of denosumab on disseminated tumor cells
({DTC}s) of breast cancer patients with neoadjuvant
treatment: a {G}epar{X} translational substudy.},
journal = {Breast cancer research},
volume = {25},
number = {1},
issn = {1465-5411},
address = {London},
publisher = {BioMed Central},
reportid = {DKFZ-2023-00628},
pages = {32},
year = {2023},
abstract = {Disseminated tumor cells (DTCs) in the bone marrow are
observed in about $40\%$ at primary diagnosis of breast
cancer and predict poor survival. While anti-resorptive
therapy with bisphosphonates was shown to eradicate minimal
residue disease in the bone marrow, the effect of denosumab
on DTCs, particularly in the neoadjuvant setting, is largely
unknown. The recent GeparX clinical trial reported that
denosumab, applied as an add-on treatment to nab-paclitaxel
based neoadjuvant chemotherapy (NACT), did not improve the
patient's pathologic complete response (pCR) rate. Herein,
we analyzed the predictive value of DTCs for the response to
NACT and interrogated whether neoadjuvant denosumab
treatment may eradicate DTCs in the bone marrow.A total of
167 patients from the GeparX trial were analyzed for DTCs at
baseline by immunocytochemistry using the pan-cytokeratin
antibody A45-B/B3. Initially DTC-positive patients were
re-analyzed for DTCs after NACT ± denosumab.At baseline,
DTCs were observed in 43/167 patients $(25.7\%)$ in the
total cohort, however their presence did not predict
response to nab-paclitaxel based NACT (pCR rates: $37.1\%$
in DTC-negative vs. $32.6\%$ DTC-positive; p = 0.713).
Regarding breast cancer subtypes, the presence of DTCs at
baseline was numerically associated with response to NACT in
TNBC patients (pCR rates: $40.0\%$ in DTC-positive vs.
$66.7\%$ in DTC-negative patients; p = 0.16). Overall,
denosumab treatment did not significantly increase the given
DTC-eradication rate of NACT (NACT: $69.6\%$ DTC-eradication
vs. NACT + denosumab: $77.8\%$ DTC-eradication; p = 0.726).
In TNBC patients with pCR, a numerical but statistically
non-significant increase of DTC-eradication after NACT +
denosumab was observed (NACT: $75\%$ DTC-eradication vs.
NACT + denosumab: $100\%$ DTC-eradication; p = 1.00).This is
the first study worldwide, demonstrating that neoadjuvant
add-on denosumab over a short-term period of 24 months does
not increase the DTC-eradication rate in breast cancer
patients treated with NACT.},
keywords = {Bone marrow (Other) / Denosumab (Other) / Disseminated
tumor cells (Other) / GeparX trial (Other) / Neoadjuvant
chemotherapy (Other)},
cin = {DD01},
ddc = {610},
cid = {I:(DE-He78)DD01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:36978142},
doi = {10.1186/s13058-023-01619-2},
url = {https://inrepo02.dkfz.de/record/274485},
}