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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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Association between the presence of CTCs before starting a new line of chemotherapy and response to treatment.Higher response rate is observed in CTC-negative patients at baseline (A). Dynamic variation of CTCs numbers before and after treatment in patients (n = 10) with at least two determinations and at least one CTC at any time point. CTCs changes did not correlate with tumor response (B).
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pone-0103918-g004: Association between the presence of CTCs before starting a new line of chemotherapy and response to treatment.Higher response rate is observed in CTC-negative patients at baseline (A). Dynamic variation of CTCs numbers before and after treatment in patients (n = 10) with at least two determinations and at least one CTC at any time point. CTCs changes did not correlate with tumor response (B).

Mentions: Response to chemotherapy was evaluated in 45 treated patients after 3 cycles and at treatment completion or progression. Sixteen (35%) patients obtained disease control (9 PR and 7 SD) and the remaining 29 (65%) had PD. The clinical control of the disease was mainly confined in patients with 0 CTC (15/33, 45%) while only one (8%) PR was observed in the 12 patients with detectable CTCs at baseline (p .03) (Figure 4A).


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)

Association between the presence of CTCs before starting a new line of chemotherapy and response to treatment.Higher response rate is observed in CTC-negative patients at baseline (A). Dynamic variation of CTCs numbers before and after treatment in patients (n = 10) with at least two determinations and at least one CTC at any time point. CTCs changes did not correlate with tumor response (B).
© Copyright Policy
Related In: Results  -  Collection

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

pone-0103918-g004: Association between the presence of CTCs before starting a new line of chemotherapy and response to treatment.Higher response rate is observed in CTC-negative patients at baseline (A). Dynamic variation of CTCs numbers before and after treatment in patients (n = 10) with at least two determinations and at least one CTC at any time point. CTCs changes did not correlate with tumor response (B).
Mentions: Response to chemotherapy was evaluated in 45 treated patients after 3 cycles and at treatment completion or progression. Sixteen (35%) patients obtained disease control (9 PR and 7 SD) and the remaining 29 (65%) had PD. The clinical control of the disease was mainly confined in patients with 0 CTC (15/33, 45%) while only one (8%) PR was observed in the 12 patients with detectable CTCs at baseline (p .03) (Figure 4A).

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