Circulating tumour cell (CTC) counts as intermediate end points in castration-resistant prostate cancer (CRPC): a single-centre experience
Circulating tumour cell (CTC) counts as intermediate end points in castration-resistant prostate cancer (CRPC): a single-centre experience
复制标题
DOI：
10.1093/annonc/mdn544
复制
发表时间：
2009-01-01
影响因子：
50.5
通讯作者：
de Bono, J. S.
中科院分区：
文献类型：
--
作者：
Olmos, D.;Arkenau, H. -T.;de Bono, J. S.
背景：本研究的目的是评估抗去势前列腺癌(CRPC)患者治疗前后循环肿瘤细胞(CTC)计数与总生存期(OS)的关系。实验设计：119例CRPC患者治疗前和治疗后各采集7.5毫升血液。使用CellSearch(R)系统对CTC进行计数。结果：CTC计数升高与预示侵袭性疾病的基线特征相关。多变量分析表明，在评估的所有时间点，CTC>；=5是一个独立的预后因素。基线CTC和>5的患者的OS比<5的患者短[中位数OS19.5vs30个月，风险比(HR)3.25，P=0.012]；CTC>；50的患者的OS比CTCs5-50的患者差(中位数OS6.3vs21.1月，HR4.1，P<；0.001)。CTC计数从基线的>；=5下降到治疗后的<；5的患者比没有这样做的患者有更好的OS。结论：CTC计数可预测OS，并为疾病进展时间提供独立的预后信息；在随机III期试验中，需要评估治疗后CTC动态变化作为结果的中间终点。
Background: The purpose of this study was to evaluate the association of circulating tumour cell (CTC) counts, before and after commencing treatment, with overall survival (OS) in patients with castration-resistant prostate cancer (CRPC).Experimental design: A 7.5 ml of blood was collected before and after treatment in 119 patients with CRPC. CTCs were enumerated using the CellSearch (R) System.Results: Higher CTC counts associated with baseline characteristics portending aggressive disease. Multivariate analyses indicated that a CTC >= 5 was an independent prognostic factor at all time points evaluated. Patients with baseline CTC >= 5 had shorter OS than those with < 5 [median OS 19.5 versus > 30 months, hazard ratio (HR) 3.25, P = 0.012]; patients with CTC > 50 had a poorer OS than those with CTCs 5-50 (median OS 6.3 versus 21.1 months, HR 4.1, P < 0.001). Patients whose CTC counts reduced from >= 5 at baseline to < 5 following treatment had a better OS compared with those who did not. CTC counts showed a similar, but earlier and independent, ability to time to disease progression to predict OS.Conclusion: CTC counts predict OS and provide independent prognostic information to time to disease progression; CTC dynamics following therapy need to be evaluated as an intermediate end point of outcome in randomised phase III trials.