Neoadjuvant Therapy is a term referring to a treatment method performed before the surgical removal of tumors. It can consist of chemotherapy, radiation, or hormone therapy. The primary goal of neoadjuvant therapy is to reduce the size of the tumor. In some cases, complete disappearance of the tumor (complete remission) can even be observed. At the end of neoadjuvant therapy, there’s usually a surgical operation to remove the remaining tumor.
maintrac® can assist in neoadjuvant therapy by monitoring the dynamics of circulating tumor cells, assessing treatment effectiveness, and raising awareness of relapses at an early stage.
Circulating Tumor Cells and Neoadjuvant Therapy
The commonly used neoadjuvant chemotherapy aims to reduce the tumor’s size before surgery. For this purpose, the initial measurement of the maintrac® cell count is taken before the first treatment cycle. This measurement is always a baseline that stands on its own. Only the trend of cell count, which requires at least one more measurement, can be interpreted.
Decreasing Cell Counts
At the beginning of chemotherapy, the cell count in the blood usually drops rapidly. During further therapy, especially when the primary tumor is destroyed, a renewed increase in cell count is typical. Treatment should be continued until the cell count decreases again. In some cases, continuing treatment after the surgery might also be sensible or necessary, especially if the cell count shows an upward trend.
Increasing Cell Counts
If the tumor doesn’t shrink under neoadjuvant therapy and at the same time, the number of circulating tumor cells increases, this indicates insufficient treatment. In consultation with the treating doctor, the therapy should be modified and continued, with cell count measurements serving as ongoing checks.
Very often, there’s a significant increase in cell count, a sign that the tumor is being attacked by chemotherapy. However, the shrinking tumor releases surviving cells into the bloodstream. This is possible even in cases of complete remission. To prevent the later formation of metastases from these circulating cells, therapy should be adjusted and continued until a decrease in circulating tumor cells becomes visible. In this scenario, maintrac® can take on the testing of drugs. Additionally, continued monitoring of the cell count trend in the postoperative situation should be carried out.
There’s also the option of a so-called neoadjuvant hormone blockade. This is further described on the “Hormone / Maintenance Therapy” page.