Tetrathiomolybdate-associated copper depletion decreases circulating endothelial progenitor cells in women with breast cancer at high risk of relapse. Academic Article uri icon

Overview

MeSH

  • Adult
  • Aged
  • Chelating Agents
  • Female
  • Humans
  • Middle Aged
  • Risk Factors

MeSH Major

  • Breast Neoplasms
  • Copper
  • Endothelial Cells
  • Molybdenum
  • Neoplasm Recurrence, Local
  • Stem Cells

abstract

  • Bone marrow-derived endothelial progenitor cells (EPCs) are critical for metastatic progression. This study explores the effect of tetrathiomolybdate (TM), an anti-angiogenic copper chelator, on EPCs in patients at high risk for breast cancer recurrence. This phase 2 study enrolled breast cancer patients with stage 3 and stage 4 without evidence of disease (NED), and stage 2 if triple-negative. TM 100 mg orally was administered to maintain ceruloplasmin <17 mg/dl for 2 years or until relapse. The primary end point was change in EPCs. Forty patients (28 stage 2/3, 12 stage 4 NED) were enrolled. Seventy-five percent patients achieved the copper depletion target by 1 month. Ninety-one percent of triple-negative patients copper-depleted compared with 41% luminal subtypes. In copper-depleted patients only, there was a significant reduction in EPCs/ml by 27 (P = 0.04). Six patients relapsed while on study, of which only one patient had EPCs maintained below baseline. The 10-month relapse-free survival was 85.0% (95% CI 74.6%-96.8%). Only grade 3/4 toxicity was hematologic: neutropenia (3.1% of cycles), febrile neutropenia (0.2%), and anemia (0.2%). TM is safe and appears to maintain EPCs below baseline in copper-depleted patients. TM may promote tumor dormancy and ultimately prevent relapse.

publication date

  • June 2013

has subject area

  • Adult
  • Aged
  • Breast Neoplasms
  • Chelating Agents
  • Copper
  • Endothelial Cells
  • Female
  • Humans
  • Middle Aged
  • Molybdenum
  • Neoplasm Recurrence, Local
  • Risk Factors
  • Stem Cells

Research

keywords

  • Clinical Trial, Phase II
  • Journal Article

Identity

Language

  • eng

PubMed Central ID

  • PMC3707432

Digital Object Identifier (DOI)

  • 10.1093/annonc/mds654

PubMed ID

  • 23406736

Additional Document Info

start page

  • 1491

end page

  • 1498

volume

  • 24

number

  • 6