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    EPAC-lung: pooled analysis of circulating tumour cells in advanced non-small cell lung cancer

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    Authors
    Lindsay, Colin R
    Blackhall, Fiona H
    Carmel, A
    Fernandez-Gutierrez, Fabiola
    Gazzaniga, P
    Groen, H
    Hiltermann, T
    Krebs, Matthew G
    Loges, S
    Lopez-Lopez, R
    Muinelo-Romay, L
    Pantel, K
    Priest, Lynsey
    Riethdorf, S
    Rossi, E
    Terstappen, L
    Wikman, H
    Soria, J
    Farace, F
    Renehan, Andrew G
    Dive, Caroline
    Besse, B
    Michiels, S
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    Affiliation
    Division of Molecular and Clinical Cancer Sciences, University of Manchester, Manchester, UK
    Issue Date
    2019
    
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    Abstract
    INTRODUCTION: We assessed the clinical validity of circulating tumour cell (CTC) quantification for prognostication of patients with advanced non-small cell lung cancer (NSCLC) by undertaking a pooled analysis of individual patient data. METHODS: Nine European NSCLC CTC centres were asked to provide reported/unreported pseudo-anonymised data for patients with advanced NSCLC who participated in CellSearch CTC studies from January 2003 to March 2017. We used Cox regression models, stratified by centres, to establish the association between CTC count and survivaL We assessed the added value of CTCs to prognostic clinicopathological models using likelihood ratio (LR) statistics and c-indices. RESULTS: Seven out of nine eligible centres provided data for 550 patients with prognostic information for overall survivaL CTC counts of >/=2 and >/= 5 per 7.5 mL were associated with reduced progression-free survival (>/=2 CTCs: hazard ratio [HR] = 1.72, p < 0.001; >/=5 CTCs: HR = 2.21, p < 0.001) and overall survival (>/=2 CTCs: HR = 2.18, p < 0.001; >/=5 CTCs: HR = 2.75, p < 0.001), respectively. Survival prediction was significantly improved by addition of baseline CTC count to LR clinicopathological models (log-transformed CTCs p < 0.001; >/=2 CTCs p < 0.001; >/=5 CTCs p </= 0.001 for both survival end-points), whereas moderate improvements were observed with the use of c-index modelS There was some evidence of between-centre heterogeneity, especially when examining continuous counts of CTCS. CONCLUSIONS: These data confirm CTCs as an independent prognostic indicator of progression-free survival and overall survival in advanced NSCLC and also reveal some evidence of between-centre heterogeneitY CTC count improves prognostication when added to full clinicopathological predictive models
    Citation
    Lindsay CR, Blackhall FH, Carmel A, Fernandez-Gutierrez F, Gazzaniga P, Groen HJM, et al. EPAC-lung: pooled analysis of circulating tumour cells in advanced non-small cell lung cancer. Eur J Cancer. 2019;117:60-8.
    Journal
    European Journal of Cancer
    URI
    http://hdl.handle.net/10541/622005
    DOI
    10.1016/j.ejca.2019.04.019
    PubMed ID
    31254940
    Additional Links
    https://dx.doi.org/10.1016/j.ejca.2019.04.019
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ejca.2019.04.019
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