Circulating tumor cells in small-cell lung cancer: a predictive and prognostic factor
Circulating tumor cells in small-cell lung cancer: a predictive and prognostic factor
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DOI：
10.1093/annonc/mds138
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发表时间：
2012-11-01
影响因子：
50.5
通讯作者：
Groen, H. J. M.
中科院分区：
文献类型：
--
作者：
Hiltermann, T. J. N.;Pore, M. M.;Groen, H. J. M.
小细胞肺癌（SCLC）对化疗的初始反应高，且经常发生复发，导致早期死亡。本研究探讨了循环肿瘤细胞（CTC）在小细胞肺癌患者中的预后价值以及CTC的变化是否可以预测化疗的反应。在这项多中心前瞻性研究中，从59例小细胞肺癌患者中采集了CTC分析的血液样本，分别在化疗前、一个周期后和化疗结束时进行。在基线时，21名局限性SCLC患者（中位数= 6，范围0-220）与38名广泛期患者（中位数= 63，范围0- 14040）相比，观察到较低数量的CTC。缺乏可测量的CTC（27%的患者）与生存期延长相关（HR 3.4; P < 0.001）。一个周期的化疗后，CTC减少;这种减少与四个周期的化疗后的肿瘤反应无关。第一个周期化疗后的CTC计数是总生存率的最强预测因子（HR 5.7; 95%CI 1.7-18.9; P = 0.004）。SCLC患者化疗一个周期后的绝对CTC是化疗反应和生存率的最强预测因子。初始CTC数低的患者比CTC数高的患者寿命更长。
Initial response of small-cell lung cancer (SCLC) to chemotherapy is high, and recurrences occur frequently, leading to early death. This study investigated the prognostic value of circulating tumor cells (CTCs) in patients with SCLC and whether changes in CTCs can predict response to chemotherapy.In this multicenter prospective study, blood samples for CTC analysis were obtained from 59 patients with SCLC before, after one cycle, and at the end of chemotherapy. CTCs were measured using CellSearch((R)) systems.At baseline, lower numbers of CTCs were observed for 21 patients with limited SCLC (median = 6, range 0-220) compared with 38 patients with extensive stage (median = 63, range 0-14 040). Lack of measurable CTCs (27% of patients) was associated with prolonged survival (HR 3.4; P < 0.001). CTCs decreased after one cycle of chemotherapy; this decrease was not associated with tumor response after four cycles of chemotherapy. CTC count after the first cycle of chemotherapy was the strongest predictor for overall survival (HR 5.7; 95% CI 1.7-18.9; P = 0.004).Absolute CTCs after one cycle of chemotherapy in patients with SCLC is the strongest predictor for response on chemotherapy and survival. Patients with low initial CTC numbers lived longer than those with higher CTCs.