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A multicenter pilot study examining the role of circulating tumor cells as a blood-based tumor marker in patients with extensive small-cell lung cancer.

Huang CH, Wick JA, Sittampalam GS, Nirmalanandhan VS, Ganti AK, Neupane PC, Williamson SK, Godwin AK, Schmitt S, Smart NJ, Spencer S, Van Veldhuizen PJ - Front Oncol (2014)

Bottom Line: A significant reduction in CTCs from baseline to post-treatment was identified for 15 subjects; the median reduction was 97.4% (range -100 to +100%, p < 0.001).Higher baseline CTCs and percentage change in post-treatment CTCs were associated with decreased survival.We demonstrated that it is feasible to detect CTCs in EX-SCLC.

View Article: PubMed Central - PubMed

Affiliation: Division of Hematology & Oncology, University of Kansas Medical Center , Westwood, KS , USA ; Subspecialty Medicine, Kansas City VA Medical Center , Kansas City, MO , USA.

ABSTRACT

Background: Small-cell lung cancer (SCLC), a variant of lung cancer marked by early metastases, accounts for 13% of all lung cancers diagnosed in US. Despite high response rates to treatment, it is an aggressive disease with a median survival of 9-11 months for patients with extensive stage (EX-SCLC). Detection of circulating tumor cells (CTCs) is a novel laboratory technique currently in use to determine response to therapy and to predict prognosis in breast, colorectal, and prostate cancer. We initiated a pilot study to analyze the role of CTCs as a biomarker of response and relapse in patients with EX-SCLC.

Methods: We collected blood samples from chemotherapy naïve patients with EX-SCLC prior to initiation of therapy, after completion of systemic therapy, and follow-up every 6-8 weeks and at relapse. The number of CTCs was determined using the cell search system in a central laboratory. The study was conducted in four different sites, and it was reviewed and approved by respective research review committees and IRBs.

Results: We enrolled 26 patients with EX-SCLC, 1 was excluded due to ineligibility, all were treated with platinum and etoposide. We observed partial response in 16 patients, stable disease in 3 patients, 1 patient with disease progression, and 6 patients were not assessed (5 deceased, 1 not available). The overall median number of CTCs in 24 patients measured at baseline and post-tx was 75 (range 0-3430) and 2 (range 0-526), respectively. A significant reduction in CTCs from baseline to post-treatment was identified for 15 subjects; the median reduction was 97.4% (range -100 to +100%, p < 0.001). Higher baseline CTCs and percentage change in post-treatment CTCs were associated with decreased survival.

Conclusion: We demonstrated that it is feasible to detect CTCs in EX-SCLC. If validated in other prospective studies, CTCs could be a useful biomarker in the management of EX-SCLC by predicting patients' clinical responses to therapy.

No MeSH data available.


Related in: MedlinePlus

Receiver operating characteristic (ROC) curves for CTCs at baseline (red, AUC = 0.7308, 95% CI: 0.36, 1.0) and change in CTCs from pre- to post-treatment (blue, AUC = 0.6795, 95% CI: 0.33, 1.0).
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Figure 4: Receiver operating characteristic (ROC) curves for CTCs at baseline (red, AUC = 0.7308, 95% CI: 0.36, 1.0) and change in CTCs from pre- to post-treatment (blue, AUC = 0.6795, 95% CI: 0.33, 1.0).

Mentions: Receiver operating characteristic (ROC) curves for classifying survival as a function of baseline CTCs and pre- to post-treatment changes in CTCs are shown in Figure 4. AUC for baseline CTCs and change in CTCs are 0.731 (95% CI: 0.36, 1.0) and 0.68 (95% CI: 0.33, 1.0), respectively.


A multicenter pilot study examining the role of circulating tumor cells as a blood-based tumor marker in patients with extensive small-cell lung cancer.

Huang CH, Wick JA, Sittampalam GS, Nirmalanandhan VS, Ganti AK, Neupane PC, Williamson SK, Godwin AK, Schmitt S, Smart NJ, Spencer S, Van Veldhuizen PJ - Front Oncol (2014)

Receiver operating characteristic (ROC) curves for CTCs at baseline (red, AUC = 0.7308, 95% CI: 0.36, 1.0) and change in CTCs from pre- to post-treatment (blue, AUC = 0.6795, 95% CI: 0.33, 1.0).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4196518&req=5

Figure 4: Receiver operating characteristic (ROC) curves for CTCs at baseline (red, AUC = 0.7308, 95% CI: 0.36, 1.0) and change in CTCs from pre- to post-treatment (blue, AUC = 0.6795, 95% CI: 0.33, 1.0).
Mentions: Receiver operating characteristic (ROC) curves for classifying survival as a function of baseline CTCs and pre- to post-treatment changes in CTCs are shown in Figure 4. AUC for baseline CTCs and change in CTCs are 0.731 (95% CI: 0.36, 1.0) and 0.68 (95% CI: 0.33, 1.0), respectively.

Bottom Line: A significant reduction in CTCs from baseline to post-treatment was identified for 15 subjects; the median reduction was 97.4% (range -100 to +100%, p < 0.001).Higher baseline CTCs and percentage change in post-treatment CTCs were associated with decreased survival.We demonstrated that it is feasible to detect CTCs in EX-SCLC.

View Article: PubMed Central - PubMed

Affiliation: Division of Hematology & Oncology, University of Kansas Medical Center , Westwood, KS , USA ; Subspecialty Medicine, Kansas City VA Medical Center , Kansas City, MO , USA.

ABSTRACT

Background: Small-cell lung cancer (SCLC), a variant of lung cancer marked by early metastases, accounts for 13% of all lung cancers diagnosed in US. Despite high response rates to treatment, it is an aggressive disease with a median survival of 9-11 months for patients with extensive stage (EX-SCLC). Detection of circulating tumor cells (CTCs) is a novel laboratory technique currently in use to determine response to therapy and to predict prognosis in breast, colorectal, and prostate cancer. We initiated a pilot study to analyze the role of CTCs as a biomarker of response and relapse in patients with EX-SCLC.

Methods: We collected blood samples from chemotherapy naïve patients with EX-SCLC prior to initiation of therapy, after completion of systemic therapy, and follow-up every 6-8 weeks and at relapse. The number of CTCs was determined using the cell search system in a central laboratory. The study was conducted in four different sites, and it was reviewed and approved by respective research review committees and IRBs.

Results: We enrolled 26 patients with EX-SCLC, 1 was excluded due to ineligibility, all were treated with platinum and etoposide. We observed partial response in 16 patients, stable disease in 3 patients, 1 patient with disease progression, and 6 patients were not assessed (5 deceased, 1 not available). The overall median number of CTCs in 24 patients measured at baseline and post-tx was 75 (range 0-3430) and 2 (range 0-526), respectively. A significant reduction in CTCs from baseline to post-treatment was identified for 15 subjects; the median reduction was 97.4% (range -100 to +100%, p < 0.001). Higher baseline CTCs and percentage change in post-treatment CTCs were associated with decreased survival.

Conclusion: We demonstrated that it is feasible to detect CTCs in EX-SCLC. If validated in other prospective studies, CTCs could be a useful biomarker in the management of EX-SCLC by predicting patients' clinical responses to therapy.

No MeSH data available.


Related in: MedlinePlus