Relationship between circulating tumour cell count and prognosis following chemotherapy in patients with advanced non‐small‐cell lung cancer

Abstract

Background and objective: This study investigated whether circulating tumour cells (CTC) are detectable in patients with non-small cell lung cancer (NSCLC) and whether CTC count could provide prognostic information or serve as an indicator of patient response to chemotherapy. Methods: We enrolled 46 patients with newly diagnosed or recurrent NSCLC. CTC were measured at baseline in all patients and in 23 patients, CTC were also measured before every chemotherapy cycle. The relationship between CTC count and tumour size was analysed. Results: CTC were present in 40 patients (87%); among them, 29 (63%) had a CTC count of ≥3 cells/ 3.2 mL, 17 (37%) had a CTC count of ≥5 cells/3.2 mL and 7 (15.2%) had a CTC count of ≥8 cells/3.2 mL. The median progression-free survival (PFS) and overall survival (OS) were 7.3 months and 16 months, respectively. A CTC count of more than eight prior to chemotherapy was a strong predictor of reduced PFS (P = 0.018) and OS (P = 0.026). A multivariate analysis indicated that baseline CTC count was an independent negative prognostic factor for survival. However, no correlation was observed between CTC count and tumour size after two chemotherapy cycles, its relationship with chemotherapy response still needs to be defined. Conclusion: Baseline CTC count is an independent negative prognostic factor for NSCLC; The relationship of CTC and survival after chemotherapy still needs to be defined.

Liquid biopsy based biomarkers in non-small cell lung cancer for diagnosis and treatment monitoring

“…A baseline CTCs count of more than eight prior to chemotherapy was a strong predictor of reduced PFS (P=0.018) and OS (P=0.026). However, no correlation was observed between CTCs count and tumor size after two chemotherapy cycles (32).…”

Clinical utility of circulating tumor cells in patients with non-small-cell lung cancer

“…Two additional studies have investigated the prognostic role of CTC on chemo-naïve patients receiving standard chemotherapy using different methods for CTC count ( (40). By using survivin mRNA as surrogate biomarker for CTC detection, CTC were detected in 54/78 (69.2%) stage IIIB and IV NSCLC before administration of chemotherapy, in 41 (52.6%) after cycle 1 of chemotherapy and in 38 (50.7%) after cycle 3 (41).…”

Clinical and Investigational Applications of Liquid Biopsy in Non-Small Cell Lung Cancer

“…A baseline CTC count of more than eight prior to chemotherapy was a strong predictor of reduced PFS (p = 0.018) and OS (p = 0.026). However, no correlation was observed between CTCs count and tumor size after two chemotherapy cycles [23] . As a potentially useful tool for clinical practice, several studies have provided evidence between decreases in CTCs counts and radiographic response by either FDG-PET/CT or RECIST to predict DFS and OS.…”