Baseline and Kinetic Circulating Tumor Cell Counts Are Prognostic Factors in a Prospective Study of Metastatic Colorectal Cancer

Virgilio Souza e Silva; Emne Ali Abdallah; Angelo Borsarelli Carvalho de Brito; Alexcia Camila Braun; Milena Shizue Tariki; Celso Abdon Lopes de Mello; Vinicius Fernando Calsavara; Rachel Riechelmann; Ludmilla Thomé Domingos Chinen

doi:10.3390/diagnostics11030502

journal article Open Access Mar 12, 2021

Baseline and Kinetic Circulating Tumor Cell Counts Are Prognostic Factors in a Prospective Study of Metastatic Colorectal Cancer

Virgilio Souza e Silva

Emne Ali Abdallah Angelo Borsarelli Carvalho de Brito Alexcia Camila Braun

Milena Shizue Tariki Celso Abdon Lopes de Mello

Vinicius Fernando Calsavara Rachel Riechelmann Ludmilla Thomé Domingos Chinen

Diagnostics Vol. 11 No. 3 pp. 502 · MDPI AG

View at Publisher Save 10.3390/diagnostics11030502

Abstract

The discovery of predictive biomarkers in metastatic colorectal cancer (mCRC) is essential to improve clinical outcomes. Recent data suggest a potential role of circulating tumor cells (CTCs) as prognostic indicators. We conducted a follow-on analysis from a prospective study of consecutive patients with mCRC. CTC analysis was conducted at two timepoints: baseline (CTC1; before starting chemotherapy), and two months after starting treatment (CTC2). CTC isolation/quantification were completed by ISET® (Rarecells, France). CTC expressions of drug resistance-associated proteins were evaluated. Progression-free survival (PFS) and overall survival (OS) were estimated by the Kaplan–Meier method. Seventy-five patients were enrolled from May 2012 to May 2014. A CTC1 cut-off of >1.5 CTCs/mL was associated with an inferior median OS compared to lower values. A difference of CTC2−CTC1 > 5.5 CTCs/mL was associated with a reduced median PFS. By multivariate analysis, CTC1 > 1.5 CTCs/mL was an independent prognostic factor for worse OS. Multi-drug resistance protein-1 (MRP-1) expression was associated with poor median OS. CTC baseline counts, kinetics, and MRP-1 expression were predictive of clinical outcomes. Larger studies are warranted to explore the potential clinical benefit of treating mCRC patients with targeted therapeutic regimens guided by CTC findings.

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Published: Mar 12, 2021
Vol/Issue: 11(3)
Pages: 502
License: View

Authors

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Virgilio Souza e Silva