T J N Hiltermann1, M M Pore2, A van den Berg3, W Timens3, H M Boezen4, J J W Liesker5, J H Schouwink6, W J A Wijnands7, G S M A Kerner8, F A E Kruyt2, H Tissing9, A G J Tibbe9, L W M M Terstappen10, H J M Groen8. 1. Departments of Pulmonary Diseases. Electronic address: t.j.n.hiltermann@umcg.nl. 2. Departments of Medical Oncology. 3. Departments of Pathology and Medical Biology. 4. Departments of Medical Epidemiology, University of Groningen, University Medical Center Groningen, Groningen. 5. Department of Pulmonary Diseases, Scheper Hospital, Emmen. 6. Department of Pulmonary Diseases, Medisch Spectrum Twente, Enschede. 7. Department of Pulmonary Diseases, Deventer Hospital, Deventer, The Netherlands. 8. Departments of Pulmonary Diseases. 9. Immunicon Corporation, Huntingdon Valley, Veridex LCC, Raritan, USA. 10. Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.
Abstract
BACKGROUND: Initial response of small-cell lung cancer (SCLC) to chemotherapy is high, and recurrences occur frequently, leading to early death. This study investigated the prognostic value of circulating tumor cells (CTCs) in patients with SCLC and whether changes in CTCs can predict response to chemotherapy. Patients and methods In this multicenter prospective study, blood samples for CTC analysis were obtained from 59 patients with SCLC before, after one cycle, and at the end of chemotherapy. CTCs were measured using CellSearch systems. RESULTS: At baseline, lower numbers of CTCs were observed for 21 patients with limited SCLC (median = 6, range 0-220) compared with 38 patients with extensive stage (median = 63, range 0-14,040). Lack of measurable CTCs (27% of patients) was associated with prolonged survival (HR 3.4; P ≤ 0.001). CTCs decreased after one cycle of chemotherapy; this decrease was not associated with tumor response after four cycles of chemotherapy. CTC count after the first cycle of chemotherapy was the strongest predictor for overall survival (HR 5.7; 95% CI 1.7-18.9; P = 0.004). CONCLUSION: Absolute CTCs after one cycle of chemotherapy in patients with SCLC is the strongest predictor for response on chemotherapy and survival. Patients with low initial CTC numbers lived longer than those with higher CTCs.
BACKGROUND: Initial response of small-cell lung cancer (SCLC) to chemotherapy is high, and recurrences occur frequently, leading to early death. This study investigated the prognostic value of circulating tumor cells (CTCs) in patients with SCLC and whether changes in CTCs can predict response to chemotherapy. Patients and methods In this multicenter prospective study, blood samples for CTC analysis were obtained from 59 patients with SCLC before, after one cycle, and at the end of chemotherapy. CTCs were measured using CellSearch systems. RESULTS: At baseline, lower numbers of CTCs were observed for 21 patients with limited SCLC (median = 6, range 0-220) compared with 38 patients with extensive stage (median = 63, range 0-14,040). Lack of measurable CTCs (27% of patients) was associated with prolonged survival (HR 3.4; P ≤ 0.001). CTCs decreased after one cycle of chemotherapy; this decrease was not associated with tumor response after four cycles of chemotherapy. CTC count after the first cycle of chemotherapy was the strongest predictor for overall survival (HR 5.7; 95% CI 1.7-18.9; P = 0.004). CONCLUSION: Absolute CTCs after one cycle of chemotherapy in patients with SCLC is the strongest predictor for response on chemotherapy and survival. Patients with low initial CTC numbers lived longer than those with higher CTCs.
Authors: M Catherine Pietanza; Anya M Litvak; Anna M Varghese; Lee M Krug; Martin Fleisher; Jerrold B Teitcher; Andrei I Holodny; Cami S Sima; Kaitlin M Woo; Kenneth K Ng; Helen H Won; Michael F Berger; Mark G Kris; Charles M Rudin Journal: Lung Cancer Date: 2016-04-26 Impact factor: 5.705