Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Effect of exemestane endocrine therapy for hormone-receptor-positive breast cancer patients with varying levels of ctDNA

Yanning Chen¹ , Qiu Huawei²

¹Harbin Medical University Cancer Hospital, 150 Haping Rd, Nangang District, China; ²Department of Laboratory, Affiliated Cancer Hospital of Harbin Medical University, Harbin, China.

For correspondence:- Yanning Chen Email: xiaoxiang19980926@163.com

Accepted: 30 November 2021 Published: 31 December 2021

Citation: Chen Y, Huawei Q. Effect of exemestane endocrine therapy for hormone-receptor-positive breast cancer patients with varying levels of ctDNA. Trop J Pharm Res 2021; 20(12):2611-2617 doi:

© 2021 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To determine the effectiveness of exemestane in the treatment of hormone receptor (HR)-positive breast cancer patients with different levels of circulating tumor DNA (ctDNA).

Methods: HR-positive breast cancer patients admitted at the Oncology Department of Harbin Medical University Cancer Hospital, Harbin, China from January 2017 to January 2019 were selected as subjects. They were given endocrine therapy with exemestane, and subjected to plasma ctDNA screening. The expression levels of ctDNA, levels of factors that influence ctDNA expression, ctDNA expression levels before and after treatment, clinical efficacy of treatment, long-term prognosis, and factors that influence prognosis of the disease, were determined.

Results: There were 57 ctDNA-positive patients and 23 ctDNA-negative patients, accounting for 71.25 % positive ctDNA expression. Post-treatment, 32 patients were ctDNA-positive, while 48 patients were ctDNA-negative. There were significant differences in age distribution, cases of lymph node metastasis, and levels of CEA, CA125 and CA153 between ctDNA-negative and ctDNA-positive groups (p < 0.05). The ORR of ctDNA-negative group was significantly higher than that of ctDNA-positive group (χ² = 6.841; p = 0.009). Decrease (Δ) in the levels of CEA, CA125 and CA153 in the ctDNA-negative group was significantly higher than those in control group (p < 0.001). The overall survival time of ctDNA-negative group was significantly better than that of ctDNA-positive group.

Conclusion: ctDNA mutations in HR-positive breast cancer patients correlated with clinical outcomes of neoadjuvant treatment with exemestane. The treatment resulted in marked reduction in number of ctDNA-positive patients.

Keywords: Hormone receptor positive breast cancer, Exemestane, Circulating tumor DNA, Clinical outcomes