Circulating Tumor Cells Count Predicts Survival in Colorectal Cancer Patients

Romiti, Adriana; Raffa, Salvatore; Rocco, Roberta Di; Roberto, Michela; Milano, Annalisa; Zullo, Angelo; Leone, Laura; Ranieri, Danilo; Mazzetta, Francesca; Medda, Emanuela; Sarcina, Ida; Barucca, Viola; D’Antonio, Chiara; Durante, Valeria; Ferri, Mario; Torrisi, Maria Rosaria; Marchetti, Paolo

doi:10.15403/jgld.2014.1121.233.arom1

Cited by 40 publications

(25 citation statements)

References 21 publications

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“…However, besides this, our results were similar to a recently published study that demonstrates a correlation of CTC kinetics in metastatic breast cancer (mBC) with prognosis and evaluation of response to the treatment adopted 39. This study with 356 mBC patients demonstrated that those with favorable CTC kinetics had a higher propensity to respond to the proposed treatment, supporting the evaluation that the dynamic counting of CTCs could better reflect the prognosis and the aggressiveness of the disease than the isolated counting of cells 37. Cohen et al28,40 in their publications on mCRC using CellSearch ® System also demonstrated the importance of CTC kinetics with evidence of increased survival for patients with conversion from unfavorable to favorable CTC condition.…”

Section: Discussionsupporting

confidence: 91%

“…Defining the initial treatment with one, two, or three medications associated or not with biological agents (monoclonal antibodies and tyrosine kinase inhibitors) becomes more difficult due to clinical and pathological complexities of mCRC and the lack of non-radiological markers that are useful for defining therapeutic strategies. In this way, evaluating the dynamics of CTCs could guide the oncologists in choosing a systemic therapy and predicting the clinical response from favorable and unfavorable patients 37,38…”

Section: Discussionmentioning

confidence: 99%

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Early detection of poor outcome in patients with metastatic colorectal cancer: tumor kinetics evaluated by circulating tumor cells

Silva¹,

Chinen²,

Abdallah³

et al. 2016

OTT

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BackgroundColorectal cancer (CRC) is the third most prevalent cancer worldwide. New prognostic markers are needed to identify patients with poorer prognosis, and circulating tumor cells (CTCs) seem to be promising to accomplish this.Patients and methodsA prospective study was conducted by blood collection from patients with metastatic CRC (mCRC), three times, every 2 months in conjunction with image examinations for evaluation of therapeutic response. CTC isolation and counting were performed by Isolation by Size of Epithelial Tumor Cells (ISET).ResultsA total of 54 patients with mCRC with a mean age of 57.3 years (31–82 years) were included. Among all patients, 60% (n=32) were carriers of wild-type KRAS (WT KRAS) tumors and 90% of them (n=29) were exposed to monoclonal antibodies along with systemic treatment. Evaluating CTC kinetics, when we compared the baseline (pretreatment) CTC level (CTC1) with the level at first follow-up (CTC2), we observed that CTC1-positive patients (CTCs above the median), who became negative (CTCs below the median) had a favorable evolution (n=14), with a median progression-free survival (PFS) of 14.7 months. This was higher than that for patients with an unfavorable evolution (CTC1− that became CTC2+; n=13, 6.9 months; P=0.06). Patients with WT KRAS with favorable kinetics had higher PFS (14.7 months) in comparison to those with WT KRAS with unfavorable kinetics (9.4 months; P=0.02). Moreover, patients whose imaging studies showed radiological progression had an increased quantification of CTCs at CTC2 compared to those without progression (P=0.04).ConclusionThis study made possible the presentation of ISET as a feasible tool for evaluating CTC kinetics in patients with mCRC, which can be promising in their clinical evaluation.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Early detection of poor outcome in patients with metastatic colorectal cancer: tumor kinetics evaluated by circulating tumor cells

Silva¹,

Chinen²,

Abdallah³

et al. 2016

OTT

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“…However, technological shortcomings and difficulty in finding the perfect markers to identify such CTCs or ctDNA have resulted in few studies of any clinically valuable difference in terms of survival outcomes or prediction[31]. Other studies appear promising, including one recent meta-analysis on the prognostic role of ctDNA[32], also for disease prediction but are small and need further validation[33-35]. …”

Section: Liquid Biopsies: Circulating Tumor Cells and Circulating Tummentioning

confidence: 99%

Can molecular biomarkers replace a clinical risk score for resectable colorectal liver metastasis?

Veen

Søreide

2017

WJGO

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In resectable colorectal liver metastasis (CRLM) the role and use of molecular biomarkers is still controversial. Several biomarkers have been linked to clinical outcomes in CRLM, but none have so far become routine for clinical decision making. For several reasons, the clinical risk score appears to no longer hold the same predictive value. Some of the reasons include the ever expanding indications for liver resection, which now increasingly tend to involve extrahepatic disease, such as lung metastases (both resectable and non-resectable) and the shift in indication from “what is taken out” (e.g., how much liver has to be resected) to “what is left behind” (that is, how much functional liver tissue the patient has after resection). The latter is amenable to modifications by using adjunct techniques of portal vein embolization and the associating liver partition and portal vein ligation for staged hepatectomy techniques to expand indications for liver resection. Added to this complexity is the increasing number of molecular markers, which appear to hold important prognostic and predictive information, for which some will be discussed here. Beyond characteristics of tissue-based genomic profiles will be liquid biopsies derived from circulating tumor cells and cell-free circulating tumor DNA in the blood. These markers are present in the peripheral circulation in the majority of patients with metastatic cancer disease. Circulating biomarkers may represent more readily available methods to monitor, characterize and predict cancer biology with future implications for cancer care.

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“…Therefore, to seek a sensitive method in the detection of potential meningeal metastasis is extremely necessary. Previous studies have identified that blood circulating tumor cells (CTCs), namely solid tumor cells falling into the blood, have a high correlation with tumor diagnosis (3), metastasis and prognosis (4,5). In the present study, CTCs in the cerebrospinal fluid (CSF) of patients with meningeal metastasis from lung cancer were detected using immunofluorescence in situ hybridization (immuno-FISH) technology and the detection value of the CTCs were evaluated in the adjuvant diagnosis of meningeal metastasis from lung cancer.…”

Section: Introductionmentioning

confidence: 99%

Detection value of tumor cells in cerebrospinal fluid in the diagnosis of meningeal metastasis from lung cancer by immuno-FISH technology

Liu

et al. 2016

Oncology Letters

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To investigate the detection value of tumor cells in cerebrospinal fluid (CSF) in the adjuvant diagnosis of meningeal metastasis from lung cancer by immunofluorescence in situ hybridization (immuno-FISH) technology. The circulating tumor cells (CTCs) in the CSF of 16 patients with meningeal metastasis from lung cancer and 8 with non-tumor diseases in the brain were detected using immuno-FISH technology. The diagnosis of meningeal metastasis from lung cancer was based on neurological symptoms, enhanced magnetic resonance imaging (MRI) scans and CSF cytological examination. The number of CTCs in the patients with meningeal metastasis from lung cancer was significantly higher than those with non-tumor diseases in the brain (P<0.01). The critical point of the maximum correct diagnostic index (Youden index) was regarded as the judging criterion for positive tumor cells in CSF according to the receiver operating characteristic curve. When there was one tumor cell in 7.5 ml CSF, the area under curve was 0.875 (95% confidence interval, 0.705~1.000). The diagnostic sensitivity, specificity, effectiveness, positive and negative predictive values were 75.0, 100.0, 83.3, 100.0 and 66.7%, respectively. There may be great clinical value in the detection of CTCs in CSF for the diagnosis of meningeal metastasis from lung cancer by immuno-FISH technology.

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Circulating Tumor Cells Count Predicts Survival in Colorectal Cancer Patients

Cited by 40 publications

References 21 publications

Early detection of poor outcome in patients with metastatic colorectal cancer: tumor kinetics evaluated by circulating tumor cells

Early detection of poor outcome in patients with metastatic colorectal cancer: tumor kinetics evaluated by circulating tumor cells

Can molecular biomarkers replace a clinical risk score for resectable colorectal liver metastasis?

Detection value of tumor cells in cerebrospinal fluid in the diagnosis of meningeal metastasis from lung cancer by immuno-FISH technology

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