The change in circulating tumor cells before and during concurrent chemoradiotherapy is associated with survival in patients with locally advanced head and neck cancer

Wang, Hung‐Ming; Wu, Min‐Hsien; Chang, Pei‐Hung; Lin, Herng Ching; Liao, C.T.; Wu, Shiquan; Hung, Tsung‐Min; Lin, Chine-Yu; Chang, Tung-Chieh; Tzu-Tsen, Yen; Hsieh, Jason Chia‐Hsun

doi:10.1002/hed.25744

Cited by 32 publications

(34 citation statements)

References 46 publications

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“…The results of the present study are in accordance with other studies investigating CTCs in solid cancers, including the head and neck, which revealed that the presence of CTCs may influence prognosis (11)(12)(13)(14)(15)(16)(17)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57) similar to what was observed in the patients in the present study (6/8 were positive to CTC preoperatively). A recent meta-analysis comprised of 17 studies confirmed the significant prognostic value of CTCs in patients with head and neck cancer, wherein positive CTCs were significantly associated with poor overall, disease-free and progression-free survival (61).…”

Section: Discussionsupporting

confidence: 92%

Detection of circulating tumor cells in patients with laryngeal cancer using ScreenCell: Comparative pre- and post-operative analysis and association with prognosis

et al. 2020

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The presence of circulating tumor cells (CTCs) in the blood of patients with metastatic breast, colorectal and prostate cancer have been widely investigated; however, few studies have examined CTCs in patients with laryngeal cancer. The present pilot study aimed to detect pre-and postoperative CTCs in the blood of patients with laryngeal cancer and evaluate the association with prognosis. Eight patients with laryngeal squamous cell carcinoma (LSCC) at stage III were included in the present study and underwent total or subtotal laryngectomy and radical bilateral neck lymph node dissection. Blood samples were collected from all patients before and after surgery at different time-points. The following processing steps were followed; preoperative blood sampling, surgery, postoperative blood sampling at 3, 6 and 12 month follow-ups, and prognostic association analysis. CTCs were retained on ScreenCell filters for cytological characterization. The presence of CTCs was associated with a less favorable prognosis, whereas a decrease of CTCs in the postoperative sampling was observed in patients who exhibited an improved therapeutic response. The results of the present pilot study revealed a possible association between the presence of CTCs and a less favorable prognosis in patients with LSCC; therefore, these preliminary findings may encourage further research into the incorporation of a liquid biopsy in the management of LSCC, as this may help identify patients with occult metastatic disease earlier and in a non-invasive manner. In addition, this approach may represent novel independent prognostic factor for use in the clinical evaluation of patients with LSCC.

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Section: Discussionsupporting

confidence: 92%

Detection of circulating tumor cells in patients with laryngeal cancer using ScreenCell: Comparative pre- and post-operative analysis and association with prognosis

et al. 2020

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“…In a combined study for metastatic breast and prostate cancer, Coumans et al demonstrated that for initially CTC-positive patients, a decrease of CTC count below the cut-off after 6-8 weeks of therapy is the best indicator of treatment response [38]. The association of therapy response and conversion from positive to negative CTC status was also demonstrated for metastatic non-small cell lung cancer, locally advanced head and neck cancer and gastric cancer [39][40][41]. Lorente et al described a 30% CTC decline 4 weeks after treatment for castration-resistant prostate cancer with initially ≥5 CTCs/7.5 mL as independently associated with OS and a more sensitive biomarker than 50% CTC decline [27].…”

Section: Discussionmentioning

confidence: 99%

Cut-Off Analysis of CTC Change under Systemic Therapy for Defining Early Therapy Response in Metastatic Breast Cancer

Deutsch

Feißt

et al. 2020

Cancers

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Detection of circulating tumor cells (CTC) can distinguish between aggressive and indolent metastatic disease in breast cancer patients and is thus considered an independent, negative prognostic factor. A clear decline in CTCs is observed in patients who respond to systemic therapy. Nevertheless, CTCs can decrease in patients experiencing disease progression during systemic therapy, too. This study aims to determine the differences between CTC decline in patients responding to therapy and those in whom disease is progressing. Therefore, CTC values were compared at the start and after one cycle of a new line of systemic therapy. In all, 108 initially CTC-positive patients (with ≥5 intact CTCs in 7.5 mL blood) were enrolled in this study and intact and apoptotic CTCs were measured via the CellSearch® system. A cut-off analysis was performed using Youden’s J statistics to differentiate between CTC change in the two groups. Here, 64 (59.3%) patients showed stable disease or partial response vs. 44 (40.7%) presenting disease progression. Median overall survival was 23 (range: 4–92) vs. 7 (2–43) months (p < 0.001). Median intact CTC count at enrollment was 15.0 (5–2760) vs. 30.5 (5–200000) cells (p = 0.39) and 2.5 (0–420) vs. 8.5 (0–15000) cells after one cycle of systemic therapy (p = 0.001). Median apoptotic CTC count at enrollment was 10.5 (0–1500) vs. 9 (0–800) cells (p = 0.475) and 1 (0–200) vs. 3 (0–250) cells after one cycle of systemic therapy (p = 0.01). A 50% reduction in baseline apoptotic CTC count represents the optimal cut-off to differentiate between therapy response and disease progression. An apoptotic CTC reduction of ≤10% is 74% specific for early disease progression.

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“…More recently, markers from liquid biopsies that are directly related to cancer cells or cancer‐produced molecules have been employed, including circulating tumor cells (CTCs), cell‐free DNA (cfDNA)/circulating tumor DNA (ctDNA), cfRNA, and exosomes . It is generally accepted that CTCs may play an important role in cancer metastasis .…”

Section: Biomarkers From Liquid Biopsiesmentioning

confidence: 99%

“…188 However, some are not always cancer-specific, giving rise to problems in distinguishing between malignant and inflammatory disease. [189][190][191][192] More recently, markers from liquid biopsies that are directly related to cancer cells or cancer-produced molecules have been employed, including circulating tumor cells (CTCs), 147,[150][151][152][153][154][155][156][157][158][159][160][161][162][163][164]193,194 cell-free DNA (cfDNA)/ circulating tumor DNA (ctDNA), [187][188][189][190][191][192]195,196 cfRNA, 184 and exosomes. [196][197][198] It is generally accepted that CTCs may play an important role in cancer metastasis.…”

Section: Biomarkers From Liquid Biopsiesmentioning

confidence: 99%

“…199 Data suggest that an elevated baseline CTC count is associated with advanced stage of HNSCC, 153,161 risk of relpase, 161 and a poor prognosis, [158][159][160]162,[166][167][168][169][170]172 while a declining CCRT could indicate an improved prognosis and treatment response. 164,172 In some patients, an increased CTC count has been observed after HNSCC treatment by surgery 153 and radiotherapy, 173 which is thought to possibly reflect stimulation of tumor cell dissemination and a poorer prognosis; although, the exact reasons for this observation remain unclear. A subgroup of CTCs express podoplanin, a known prognostic factor for HNSCC.…”

Section: Biomarkers From Liquid Biopsiesmentioning

confidence: 99%

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Review of emerging biomarkers in head and neck squamous cell carcinoma in the era of immunotherapy and targeted therapy

Hsieh

Wang

et al. 2019

Head & Neck

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Background Biomarkers in head and neck squamous cell carcinoma (HNSCC) emerge rapidly in recent years, especially for new targeted therapies and immunotherapies. Methods Recent, relevant peer‐reviewed evidence were critically reviewed and summarized. Results This review article briefly introduces essential biomarker concepts, including purposes and classifications (predictive, prognostic, and diagnostic markers), and the phases of biomarker development. We summarize current biomarkers in order of clinical utility; p16 and human papillomavirus status remain the most important and validated biomarkers in HNSCC. The rationale for biomarker study design continues to evolve with technological advances, especially whole‐exome or whole‐genomic sequencing. Noninvasive body fluid and liquid biopsy biomarkers appear to hold strong potential for development as tools for early cancer detection, cancer diagnosis, monitoring of disease recurrence, and outcome prediction. In light of discrepancies among different technologies, standardized approaches are needed. Conclusion Biomarkers from cancer tissue or blood in HNSCC could direct new anticancer therapies.

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The change in circulating tumor cells before and during concurrent chemoradiotherapy is associated with survival in patients with locally advanced head and neck cancer

Cited by 32 publications

References 46 publications

Detection of circulating tumor cells in patients with laryngeal cancer using ScreenCell: Comparative pre- and post-operative analysis and association with prognosis

Detection of circulating tumor cells in patients with laryngeal cancer using ScreenCell: Comparative pre- and post-operative analysis and association with prognosis

Cut-Off Analysis of CTC Change under Systemic Therapy for Defining Early Therapy Response in Metastatic Breast Cancer

Review of emerging biomarkers in head and neck squamous cell carcinoma in the era of immunotherapy and targeted therapy

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