Article

Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer.

Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111-2497, USA.
Annals of Oncology (impact factor: 6.43). 03/2009; 20(7):1223-9. DOI:10.1093/annonc/mdn786 pp.1223-9
Source: PubMed

ABSTRACT We demonstrated that circulating tumor cell (CTC) number at baseline and follow-up is an independent prognostic factor in metastatic colorectal cancer (mCRC). This analysis was undertaken to explore whether patient and treatment characteristics impact the prognostic value of CTCs.
CTCs were enumerated with immunomagnetic separation from the blood of 430 patients with mCRC at baseline and on therapy. Patients were stratified into unfavorable and favorable prognostic groups based on CTC levels of > or = 3 or <3 CTCs/7.5 ml, respectively. Subgroups were analyzed by line of treatment, liver involvement, receipt of oxaliplatin, irinotecan, or bevacizumab, age, and Eastern Cooperative Oncology Group performance status (ECOG PS).
Seventy-one percent of deaths have occurred. Median follow-up for living patients is 25.8 months. For all patients, progression-free survival (PFS) and overall survival (OS) for unfavorable compared with favorable baseline CTCs is shorter (4.4 versus 7.8 m, P = 0.004 for PFS; 9.4 versus 20.6 m, P < 0.0001 for OS). In all patient subgroups, unfavorable baseline CTC was associated with inferior OS (P < 0.001). In patients receiving first- or second-line therapy (P = 0.003), irinotecan (P = 0.0001), having liver involvement (P = 0.002), >/=65 years (P = 0.0007), and ECOG PS of zero (P = 0.04), unfavorable baseline CTC was associated with inferior PFS.
Baseline CTC count is an important prognostic factor within specific subgroups defined by treatment or patient characteristics.

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    PLoS ONE 01/2012; 7(5):e33788. · 4.09 Impact Factor
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Keywords

Baseline CTC count
 
circulating tumor cell
 
CTC levels
 
ECOG PS
 
favorable baseline CTCs
 
favorable prognostic groups
 
independent prognostic factor
 
inferior OS
 
inferior PFS
 
Median follow-up
 
metastatic colorectal cancer
 
patient characteristics
 
patient subgroups
 
Patients
 
prognostic factor
 
prognostic value
 
progression-free survival
 
second-line therapy
 
treatment characteristics impact
 
unfavorable baseline CTC
 

S J Cohen