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Ann Oncol. 2017 Jul 1;28(7):1523-1531. doi: 10.1093/annonc/mdx156.

A prospective examination of circulating tumor cell profiles in non-small-cell lung cancer molecular subgroups.

Author information

1
INSERM U981, University of Paris-Sud XI, Translational Research Laboratory, Gustave Roussy Cancer Campus, Villejuif, France.
2
Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, Villejuif, France.
3
Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France.
4
Drug Development Department, Gustave Roussy Cancer Campus, Villejuif, France.
5
Department of Radiology, Gustave Roussy Cancer Campus, Villejuif, France.

Abstract

Background:

We report the first study examining the clinical, numerical and biological properties of circulating tumor cells according to molecular subtypes of non-small-cell lung cancer.

Patients and methods:

125 patients with treatment-naïve stage IIIb-IV NSCLC were prospectively recruited for CellSearch analysis. Anti-vimentin antibody was included for examination of CTCs to assess their mesenchymal character. Associations of total CTCs and vimentin-positive (vim +) CTCs with clinical characteristics, tumor genotype, and survival were assessed.

Results:

51/125 patients (40.8%) were total CTC+ and 26/125 (20.8%) were vim CTC+ at baseline. Multivariate analysis showed patients with ≥5 total CTCs had significantly reduced OS (HR 0.55, 95% CI 0.33-0.92, P = 0.022) but not PFS (HR 0.68, 95% CI 0.42-1.1, P = 0.118) compared to patients with <5 total CTCs. No OS difference was evident between vim+ CTC and vim-negative CTC patients overall (HR 1.24, 95% CI 0.67-2.28, P = 0.494), but after subdivision according to NSCLC driver mutation, we found an increase of vim+ CTCs in the EGFR-mutated subgroup (N = 21/94 patients; mean 1.24 vs 1.22 vim+ CTCs, P = 0.013), a reduction of total CTCs in the ALK-rearranged subgroup (N = 13/90 patients; mean 1.69 vs 5.82 total CTCs, P = 0.029), and a total absence of vim+ CTCs in KRAS-mutated adenocarcinomas (N = 19/78 patients; mean 0 vs 1.4 vim+ CTCs, P = 0.006).

Conclusions:

We validate that the baseline presence of ≥5 total CTCs in advanced NSCLC confers a poor prognosis. CTCs from EGFR-mutant NSCLC express epithelial-mesenchymal transition characteristics, not seen in CTCs from patients with KRAS-mutant adenocarcinoma.

KEYWORDS:

CTC; EMT; biomarker; circulating tumor cell; non-small-cell lung cancer; vimentin

PMID:
28633480
DOI:
10.1093/annonc/mdx156
[Indexed for MEDLINE]

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