Clinical value of circulating endothelial cell levels in metastatic colorectal cancer patients treated with first-line chemotherapy and bevacizumab
Clinical value of circulating endothelial cell levels in metastatic colorectal cancer patients treated with first-line chemotherapy and bevacizumab
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DOI：
10.1093/annonc/mdr365
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发表时间：
2012-04-01
影响因子：
50.5
通讯作者：
Farace, F.
中科院分区：
文献类型：
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作者：
Malka, D.;Boige, V.;Farace, F.
背景资料：我们研究了在转移性结直肠癌（mCRC）患者中循环内皮细胞（CEC）是否预测一线化疗和贝伐单抗的临床结果。在随机II期FNCLCC雅阁13/0503试验的子研究中，在基线和治疗一个周期后，通过四色流式细胞术对99例患者的CEC（CD 45-CD 31 + CD 146 + 7-氨基放线菌素细胞）进行计数。我们将CEC水平与客观缓解率（ORR）、6个月无进展生存期（PFS）率（试验的主要终点）、PFS和总生存期（OS）相关。结果：多因素分析显示，高CEC水平是影响6个月无进展生存率的唯一独立预后因素（P < 0.01），且与无进展生存率相关（P = 0.02）。1个周期后CEC水平升高是ORR的唯一独立预后因素（P = 0.03）。两个时间点的高CEC水平独立预测ORR（P = 0.025）、6个月PFS率（P = 0.007）和PFS（P = 0.02）较差。Kohne评分是唯一与OS.Conclusion相关的变量：基线时和一个治疗周期后的CEC水平可以独立预测开始一线贝伐单抗和化疗的mCRC患者的ORR和PFS。
Background: We investigated whether circulating endothelial cells (CECs) predict clinical outcome of first-line chemotherapy and bevacizumab in metastatic colorectal cancer (mCRC) patients.Patients and methods: In a substudy of the randomized phase II FNCLCC ACCORD 13/0503 trial, CECs (CD45-CD31+CD146+ 7-amino-actinomycin- cells) were enumerated in 99 patients by four-color flow cytometry at baseline and after one cycle of treatment. We correlated CEC levels with objective response rate (ORR), 6-month progression-free survival (PFS) rate (primary end point of the trial), PFS, and overall survival (OS). Multivariate analyses of potential prognostic factors, including CEC counts and Kohne score, were carried out.Results: By multivariate analysis, high baseline CEC levels were the only independent prognostic factor for 6-month PFS rate (P < 0.01) and were independently associated with worse PFS (P = 0.02). High CEC levels after one cycle were the only independent prognostic factor for ORR (P = 0.03). High CEC levels at both time points independently predicted worse ORR (P = 0.025), 6-month PFS rate (P = 0.007), and PFS (P = 0.02). Kohne score was the only variable associated with OS.Conclusion: CEC levels at baseline and after one treatment cycle may independently predict ORR and PFS in mCRC patients starting first-line bevacizumab and chemotherapy.