PURPOSE: Circulating tumor cells (CTC) have been recently accepted by the Food and Drug Administration of the United States as a prognostic tool in advanced prostate cancer. However, a number of questions remain about the use of the test. The optimal clinical cut-off has never been determined. Also, the predictive value of CTCs in the setting of low-burden advanced prostate cancer has not been evaluated. Herein we describe our experience with the CellSearch method of CTC enumeration. EXPERIMENTAL DESIGN: CTCs enumerated from 100 patients with castration-resistant prostate cancer were correlated with clinicopathologic characteristics and conventional biomarkers, such as prostate-specific antigen and lactate dehydrogenase. Patients received ongoing medical oncologic follow-up for up to 26 months, and overall survival status was documented. RESULTS: Forty-nine of the patients (49%) were alive at the end of the study. CTC counts correlate well with overall survival (P < 0.001) but are also tightly interrelated to other biomarkers. Threshold analysis identified 4 CTC/7.5 cc (compared with the approved value of 5) as an optimal cut-off value with respect to correlation with survival outcomes as well as predictive of metastatic disease. Univariate analysis confirmed a tight interrelationship between cut-off CTC values and biomarkers. Multivariate analysis with bootstrap sampling validation identified lactate dehydrogenase (P = 0.002) and CTCs (P = 0.001) as independently prognostically significant. CONCLUSIONS: Baseline CTC values provide important prognostic information and specific prediction of metastatic disease. Their presence correlates with classic biomarkers.
PURPOSE: Circulating tumor cells (CTC) have been recently accepted by the Food and Drug Administration of the United States as a prognostic tool in advanced prostate cancer. However, a number of questions remain about the use of the test. The optimal clinical cut-off has never been determined. Also, the predictive value of CTCs in the setting of low-burden advanced prostate cancer has not been evaluated. Herein we describe our experience with the CellSearch method of CTC enumeration. EXPERIMENTAL DESIGN: CTCs enumerated from 100 patients with castration-resistant prostate cancer were correlated with clinicopathologic characteristics and conventional biomarkers, such as prostate-specific antigen and lactate dehydrogenase. Patients received ongoing medical oncologic follow-up for up to 26 months, and overall survival status was documented. RESULTS: Forty-nine of the patients (49%) were alive at the end of the study. CTC counts correlate well with overall survival (P < 0.001) but are also tightly interrelated to other biomarkers. Threshold analysis identified 4 CTC/7.5 cc (compared with the approved value of 5) as an optimal cut-off value with respect to correlation with survival outcomes as well as predictive of metastatic disease. Univariate analysis confirmed a tight interrelationship between cut-off CTC values and biomarkers. Multivariate analysis with bootstrap sampling validation identified lactate dehydrogenase (P = 0.002) and CTCs (P = 0.001) as independently prognostically significant. CONCLUSIONS: Baseline CTC values provide important prognostic information and specific prediction of metastatic disease. Their presence correlates with classic biomarkers.
Authors: Kian Behbakht; Michael W Sill; Kathleen M Darcy; Stephen C Rubin; Robert S Mannel; Steven Waggoner; Russell J Schilder; Kathy Q Cai; Andrew K Godwin; R Katherine Alpaugh Journal: Gynecol Oncol Date: 2011-07-12 Impact factor: 5.482
Authors: Chun-Liang Chen; Devalingam Mahalingam; Pawel Osmulski; Rohit R Jadhav; Chiou-Miin Wang; Robin J Leach; Tien-Cheng Chang; Steven D Weitman; Addanki Pratap Kumar; Luzhe Sun; Maria E Gaczynska; Ian M Thompson; Tim Hui-Ming Huang Journal: Prostate Date: 2012-12-31 Impact factor: 4.104
Authors: Mark Thalgott; Brigitte Rack; Tobias Maurer; Michael Souvatzoglou; Matthias Eiber; Veronika Kreß; Matthias M Heck; Ulrich Andergassen; Roman Nawroth; Jürgen E Gschwend; Margitta Retz Journal: J Cancer Res Clin Oncol Date: 2013-01-29 Impact factor: 4.553