Application of Circulating Tumor Cells and Circulating Free DNA from Peripheral Blood in the Prognosis of Advanced Gastric Cancer

Abstract

Objective. To explore the application value of circulating tumor cells (CTCs) and circulating free DNA (cfDNA) from peripheral blood in the prognosis of advanced gastric cancer (AGC). Here, we measured CTCs and cfDNA quantity for predicting the outcome of patients. Patients and Methods. Forty-five patients with advanced gastric cancer who underwent neoadjuvant chemotherapy and surgical treatment were enrolled in this study. All patients received neoadjuvant chemotherapy with paclitaxel + S-1 + oxaliplatin (PSOX) regimen, and CTCs and cfDNA of the peripheral blood were detected before and after neoadjuvant therapy. Relationships between the number/type of CTC or cfDNA and the efficacy of neoadjuvant chemotherapy were analyzed. Results. Among 45 patients, 43 (95.6%) were positive, and the positive rate of mesenchymal CTC was increased with the increase in the T stage. The proportion of mesenchymal CTC was positively correlated with the N stage ( P < 0.05 ), and the larger N stage will have the higher proportion of mesenchymal CTC. Patients with a small number of mesenchymal CTC before neoadjuvant chemotherapy were more likely to achieve partial response (PR) with neoadjuvant therapy. Patients with positive CA-199 were more likely to achieve PR with neoadjuvant therapy ( P < 0.05 ). Patients in the PR group were more likely to have decreased/unchanged cfDNA concentration after neoadjuvant therapy ( P = 0.119 ). After neoadjuvant therapy (before surgery), the cfDNA concentration was higher and the efficacy of neoadjuvant therapy (SD or PD) was lower ( P = 0.045 ). Conclusions. Peripheral blood CTC, especially interstitial CTC and cfDNA, has a certain value in predicting the efficacy and prognosis of neoadjuvant chemotherapy in advanced gastric cancer.

Minimal residual disease guided radical chemoradiotherapy combined with immunotherapy after neoadjuvant immunochemotherapy followed by adjuvant immunotherapy for esophageal squamous cell cancer (ECMRD-001): a study protocol for a prospective cohort study

“…Compared with MRD testing of CTC, ctDNA testing is more sensitive, can predict acquired drug resistance, and is more widely used, and has been recommended by several guidelines and expert consensus. In addition, the latest research shows that the combination of CTC and ctDNA can more accurately monitor the presence of MRD in solid tumors after surgery and achieve accurate recurrence prediction ( 26 , 27 ), and the combination of CTC and ctDNA opens up a new era of accurate MRD monitoring.…”

Clinical application and detection techniques of liquid biopsy in gastric cancer

“…Predicts treatment response and prognosis in GC patients [31] CTC-PD-L1 Predicting the efficacy and prognosis of neoadjuvant chemotherapy for progressive GC [38] conclusion points out that although CTCs were not associated with the T or N stages, the detection rate of CTCs in patients with T1 and N0 stages GC was more than 80%. Similarly, Tang et al [28] found that the sensitivity of using CTCs to detect patients with advanced GC was higher than that of detecting patients with early GC, but the specificity was almost the same.…”

“…After meta-analysis, they discovered that the incidence of CTCs in stage I/II GC was lower than in stage III/IV GC. In addition, Matsusaka et al [ 34 ] and Yu et al [ 38 ] identified CTCs in patients with progressive GC treated with neoadjuvant chemotherapy and surgery, and the OS and progression-free survival (PFS) were significantly shorter in patients treated with GC chemotherapy with a high number of CTCs. Therefore, all the preceding studies suggest that evaluating CTCs may be useful for predicting tumor progression and prognosis in GC patients.…”

Next‐generation liquid biopsy instruments: Challenges and opportunities

“…Furthermore, most LB instruments can only isolate biomarkers and are unable to conduct necessary subsequent analyses. For example, the Parsortix (ANGLE, UK) and ClearCell FX (Biolidics, SG) platforms were designed for CTC isolation [32,33]; the KminTrak (Surexam, CN) and the Aurora (Boreal Genomics, USA) instrument is used for cfDNA extraction typically [34,35], whereas the Automatic Fraction Collector V2 (Izon Science, NZL) can only serve as a pretreatment unit for exosome isolation [36]. Furthermore, most LB instruments require complex biochemical operations, even during the biomarker isolation process, which further impairs their automation levels.…”