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Circulating tumor cells in patients with recurrent or metastatic head and neck carcinoma: prognostic and predictive significance.

Grisanti S, Almici C, Consoli F, Buglione M, Verardi R, Bolzoni-Villaret A, Bianchetti A, Ciccarese C, Mangoni M, Ferrari L, Biti G, Marini M, Ferrari VD, Nicolai P, Magrini SM, Berruti A - PLoS ONE (2014)

Bottom Line: In multivariate analysis, the presence of one CTC or more was associated with a poor prognosis both in terms of progression-free survival (PFS) [Hazard Ratio (HR): 3.068, 95% confidence interval (CI): 1.53-6.13, p 0.002] and overall survival (OS) [HR: 3.0, 95% CI: 1.48-6.0, p 0.002].In conclusion, CTCs are detected in one out of three patients with RM-HNC.The frequency of EGFR expression in CTCs seems to be lower than that expected in the primary tumor.

View Article: PubMed Central - PubMed

Affiliation: Medical Oncology Unit, University of Brescia and Spedali Civili Hospital, Brescia, Italy.

ABSTRACT

Introduction: We investigated the frequency of detection and the prognostic and predictive significance of circulating tumor cells (CTCs) in patients with recurrent/metastatic (R/M) head and neck carcinoma (HNC) before starting systemic therapy.

Patients and methods: Using the CellSearch technology, CTCs were assessed prospectively in peripheral blood of 53 R/M-HNC patients. We performed spiking experiments to test the diagnostic performance of the CellSearch platform in identifying squamous carcinoma cells.

Results: CTCs were identified in 14 (26%) and 22 (41%) patients at baseline and at any time point, respectively. In univariate analysis ≥2 CTCs had a poorer prognostic role than 0-1 CTC. In multivariate analysis, the presence of one CTC or more was associated with a poor prognosis both in terms of progression-free survival (PFS) [Hazard Ratio (HR): 3.068, 95% confidence interval (CI): 1.53-6.13, p 0.002] and overall survival (OS) [HR: 3.0, 95% CI: 1.48-6.0, p 0.002]. A disease control after systemic therapy was obtained in 8% of CTC-positive patients as opposed to 45% in CTC-negative ones (p 0.03). The epidermal growth factor receptor (EGFR) expression was identified in 45% of CTC-positive patients.

Discussion: In conclusion, CTCs are detected in one out of three patients with RM-HNC. CTC detection is a strong prognostic parameter and may be predictive of treatment efficacy. The frequency of EGFR expression in CTCs seems to be lower than that expected in the primary tumor.

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Related in: MedlinePlus

Kaplan-Meier curves of (A) progression-free survival and (B) overall survival in patients with 0, 1 and ≥2 CTCs.
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pone-0103918-g002: Kaplan-Meier curves of (A) progression-free survival and (B) overall survival in patients with 0, 1 and ≥2 CTCs.

Mentions: At the date of last follow-up (March 2012) all patients had progressed and died. In the overall population median PFS and OS from CTC analysis were 4 and 7 months, respectively. Median PFS in patients with 0, 1 and ≥2 CTCs at baseline were 5 months (95% CI 3.9–6.0), 5 months (95% CI 0.1–10.8) and 1 month (95% CI 0.8–1.6), respectively, (log-rank test p<.0005). Median OS in patients with 0, 1 and ≥2 CTCs at baseline were 9 months (95% CI 6.9–11.0), 7 months (95% CI 4.2–9.7) and 2 months (95% CI 0.1–4.1) respectively, (log-rank test p<.0005) (Figure 2A and 2B). These results indicate that ≥2 CTCs rather than 1 CTC might be a better cutoff indicator for both PFS and OS.


Circulating tumor cells in patients with recurrent or metastatic head and neck carcinoma: prognostic and predictive significance.

Grisanti S, Almici C, Consoli F, Buglione M, Verardi R, Bolzoni-Villaret A, Bianchetti A, Ciccarese C, Mangoni M, Ferrari L, Biti G, Marini M, Ferrari VD, Nicolai P, Magrini SM, Berruti A - PLoS ONE (2014)

Kaplan-Meier curves of (A) progression-free survival and (B) overall survival in patients with 0, 1 and ≥2 CTCs.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126745&req=5

pone-0103918-g002: Kaplan-Meier curves of (A) progression-free survival and (B) overall survival in patients with 0, 1 and ≥2 CTCs.
Mentions: At the date of last follow-up (March 2012) all patients had progressed and died. In the overall population median PFS and OS from CTC analysis were 4 and 7 months, respectively. Median PFS in patients with 0, 1 and ≥2 CTCs at baseline were 5 months (95% CI 3.9–6.0), 5 months (95% CI 0.1–10.8) and 1 month (95% CI 0.8–1.6), respectively, (log-rank test p<.0005). Median OS in patients with 0, 1 and ≥2 CTCs at baseline were 9 months (95% CI 6.9–11.0), 7 months (95% CI 4.2–9.7) and 2 months (95% CI 0.1–4.1) respectively, (log-rank test p<.0005) (Figure 2A and 2B). These results indicate that ≥2 CTCs rather than 1 CTC might be a better cutoff indicator for both PFS and OS.

Bottom Line: In multivariate analysis, the presence of one CTC or more was associated with a poor prognosis both in terms of progression-free survival (PFS) [Hazard Ratio (HR): 3.068, 95% confidence interval (CI): 1.53-6.13, p 0.002] and overall survival (OS) [HR: 3.0, 95% CI: 1.48-6.0, p 0.002].In conclusion, CTCs are detected in one out of three patients with RM-HNC.The frequency of EGFR expression in CTCs seems to be lower than that expected in the primary tumor.

View Article: PubMed Central - PubMed

Affiliation: Medical Oncology Unit, University of Brescia and Spedali Civili Hospital, Brescia, Italy.

ABSTRACT

Introduction: We investigated the frequency of detection and the prognostic and predictive significance of circulating tumor cells (CTCs) in patients with recurrent/metastatic (R/M) head and neck carcinoma (HNC) before starting systemic therapy.

Patients and methods: Using the CellSearch technology, CTCs were assessed prospectively in peripheral blood of 53 R/M-HNC patients. We performed spiking experiments to test the diagnostic performance of the CellSearch platform in identifying squamous carcinoma cells.

Results: CTCs were identified in 14 (26%) and 22 (41%) patients at baseline and at any time point, respectively. In univariate analysis ≥2 CTCs had a poorer prognostic role than 0-1 CTC. In multivariate analysis, the presence of one CTC or more was associated with a poor prognosis both in terms of progression-free survival (PFS) [Hazard Ratio (HR): 3.068, 95% confidence interval (CI): 1.53-6.13, p 0.002] and overall survival (OS) [HR: 3.0, 95% CI: 1.48-6.0, p 0.002]. A disease control after systemic therapy was obtained in 8% of CTC-positive patients as opposed to 45% in CTC-negative ones (p 0.03). The epidermal growth factor receptor (EGFR) expression was identified in 45% of CTC-positive patients.

Discussion: In conclusion, CTCs are detected in one out of three patients with RM-HNC. CTC detection is a strong prognostic parameter and may be predictive of treatment efficacy. The frequency of EGFR expression in CTCs seems to be lower than that expected in the primary tumor.

Show MeSH
Related in: MedlinePlus