[Skip to Navigation]
Views 1,546
Citations 0
Editorial
November 5, 2020

Evaluating the Clinical Utility of Circulating Tumor Cells in Metastatic Breast Cancer—Is Not Worse Good Enough?

Author Affiliations
  • 1Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis
  • 2Research Advocacy Network, Plano, Texas
JAMA Oncol. 2021;7(1):30-31. doi:10.1001/jamaoncol.2020.5460

Recent decades have brought meaningful improvements in outcomes for patients with metastatic hormone receptor–positive, ERBB2-negative breast cancer. Discovery of effective adjuncts to hormonal therapy has improved quality of life and survival in the endocrine-sensitive and resistant settings. Several randomized trials and meta-analyses demonstrate the benefit of modern hormonal therapy–based treatments over traditional cytotoxic chemotherapy approaches.1 Although practice guidelines routinely recommend initial hormone-based therapy,2,3 many clinicians and patients struggle to defer chemotherapy in those with symptomatic or high-burden disease. We assume that some patients might be better served by up-front chemotherapy, but which patients? Without predictive biomarkers, we are left with our clinical knowledge, experience, and intuition. Patients are left with uncertainty, doubt, and fear.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×