Association of circulating tumour cells with early relapse and 18F-fluorodeoxyglucose positron emission tomography uptake in resected non-small-cell lung cancers†

Abstract

Detection of CTCs 1 month after radical resection might be a useful marker to predict early recurrence in Stage I-III NSCLC. The SUVmax value of the primary tumour on preoperative PET scans was associated with the presence of CTC 1 month after the operation.

Circulating Tumor Cells and Metabolic Parameters in NSCLC Patients Treated with Checkpoint Inhibitors

“…Hence, residual CTC after chemotherapy could be characterized in order to identify those morphological or genetic modification-inducing expression of genes and proteins conferring drug-resistance, such as the endothelial to mesenchymal transition observed in cancer stem cells [27,28]. In line with previous studies, we did not find a significant association between CTC and clinicopathological characteristics (e.g., age, gender, tobacco exposure, tumor size, and histologic subtype) in patients with advanced NSCLC [14,29,30]. Moreover, CTC count both at baseline and after 8 weeks, as well as their change during treatment, was not associated with tumor response according to morphologic criteria (RECIST 1.1), although a trend of significance with higher mean number of CTC for the PD group (p = 0.076) was evident.…”

“…Because our paper is the first in the era of checkpoint inhibitors investigating CTC and 18F-FDG PET parameters, comparison with other reports is not well applicable. Previously, some studies demonstrated a significant correlation between CTC and SUV value in patients with chemotherapy-naïve lung cancer [12][13][14]31]. On the contrary, Nygaard et al did not find any association between metabolic parameters and cell-free (cf) DNA, another tumor-derived biomarker [32].…”

“…Indeed, by differentiating higher versus less-active metabolic tumor tissues, semi-quantitative metabolic parameters can offer the possibility for non-invasive, in vivo tumor characterization and for correct evaluation of tumor response [9][10][11]. However, available studies analyzing the association between 18F-FDG PET/CT and CTC in NSCLC are limited to chemotherapy-naïve patients or those treated with "traditional" antitumor drugs [12][13][14][15].…”

Liquid biopsies and molecular imaging: friends or foes?

“…The presence of CTCs2 was significantly correlated with preoperative tumour maximum standardised uptake value (SUV max ) on 18F-FDG PET/CT, pathological stage and surgical approach (thoracotomy or video-assisted thoracic surgery), and it was associated with recurrence-free survival (RFS) on multivariate analysis, independently of disease staging. CTCs2 were significantly correlated with a shorter RFS, and only SUV max was an independent predictor for the presence of CTCs2 [16].…”

“…A single-centre prospective study in patients with untreated stage I-IIIA non-small cell lung cancer (NSCLC), who underwent radical resection, detected CTCs in 39.2% of patients before (CTCs1) and in 27.5% 1 month after the surgery (CTCs2) [16]. The presence of CTCs2 was significantly correlated with preoperative tumour maximum standardised uptake value (SUV max ) on 18F-FDG PET/CT, pathological stage and surgical approach (thoracotomy or video-assisted thoracic surgery), and it was associated with recurrence-free survival (RFS) on multivariate analysis, independently of disease staging.…”