Adjuvant (supporting) therapy describes treatment measures taken after a surgical removal of tumors has been carried out.
Its purpose is to help fight off any remaining tumor cells left in the body after surgery, as well as any micro-metastases which cannot be detected around the body yet. With these measures, long-term prognoses improve.
maintrac® can be used to check whether the number of tumor cells left in the blood increases or decreases. In addition to monitoring the success of treatment, a determination can also be made before treatment as to whether the drug will be effective against the tumor cells circulating in the blood werden.
During the adjuvant stage of treatment, the following rule usually applies:
- If the cell count decreases, the therapy is working.
- If the cell count increases despite the therapy, optimization of the therapy should be considered.
Response of circulating tumor cells in adjuvant therapy
Adjuvant chemotherapy generally involves a series of therapy cycles at two to three week intervals. The first maintrac® cell count is carried out 2-3 weeks after the surgery, or before chemotherapy. A further analysis is performed after the second cycle of treatment.
The first measured value of the maintrac® cell count is always used as a basis value, which has little significance when considered alone. Only the cell count progression, which can be seen after further measurements are taken, can be interpreted.
Decreasing cell counts
Experience has shown that the number of circulating tumor cells in the blood decreases where there has been a good response to therapy after the first 1-3 cycles. If the cell count reduces and stays at a low level until the end of chemotherapy, this indicates a positive, subsequent progress. In studies with non-metastatic breast cancer patients, 90-95 % of patients stayed relapse-free (without new tumors) even after 4-5 years, if they were showing a 10-fold drop in cell count before.
Even if circulating tumor cells in the blood have completely disappeared due to a good response to therapy, treatment should under no circumstances be discontinued early. Cells may still be hidden within the tissues of the body, potentially only being fully eliminated after the complete course of therapy.
Constant cell counts
The circulating tumor cells seem to only respond to chemotherapy to a limited extent. Despite this, they seem to only exhibit a limited growth trend as well. This course usually indicates a positive future outcome.
Increasing cell counts
If the cell count continually increases over the course of the adjuvant therapy, or increases after an initial drop off in cell numbers at the beginning of treatment, then the therapy is no longer, or indeed may never have been effective. The tumor cells are still active. In this case, the therapy should be optimized as the prognosis for future outcomes would otherwise be unfavorable. Here, maintrac® can test whether substances exist which could be more effective. If a continuous increase in the cell count, or a greater than 10-fold increase in cell count can be seen in non-metastatic breast cancer patients, then 65-70% of cases will suffer a relapse within the first 4-5 years.
Are you looking for more information on adjuvant hormone blocking? You can find this on the “hormone/ maintenance therapy” page.