EPAC-lung: European pooled analysis of the prognostic value of circulating tumour cells in small cell lung cancer
Authors
Foy, VictoriaLindsay, Colin R
Carmel, A.
Fernandez-Gutierrez, Fabiola
Krebs, Matthew G
Priest, Lynsey
Carter, Mathew
Groen, H. J. M.
Hiltermann, T. J. N.
de Luca, A.
Farace, F.
Besse, B.
Terstappen, L.
Rossi, E.
Morabito, A.
Perrone, F.
Renehan, Andrew G
Faivre-Finn, Corinne
Normanno, N.
Dive, Caroline
Blackhall, Fiona H
Michiels, S.
Affiliation
Cancer Research UK Manchester Institute Cancer Biomarker Centre, Cancer Research UK Manchester Institute, University of Manchester, Manchester, UIssue Date
2021
Metadata
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Background: Circulating tumour cell (CTC) number is an independent prognostic factor in patients with small cell lung cancer (SCLC) but there is no consensus on the CTC threshold for prognostic significance. We undertook a pooled analysis of individual patient data to clinically validate CTC enumeration and threshold for prognostication. Methods: Four European cancer centres, experienced in CellSearch CTC enumeration for SCLC provided pseudo anonymised data for patients who had undergone pre-treatment CTC count. Data was collated, and Cox regression models, stratified by centre, explored the relationship between CTC count and survival. The added value of incorporating CTCs into clinico-pathological models was investigated using likelihood ratio tests. Results: A total of 367 patient records were evaluated. A one-unit increase in log-transformed CTC counts corresponded to an estimated hazard ratio (HR) of 1.24 (95% CI: 1.19-1.29, P<0.0001) for progression free survival (PFS) and 1.23 (95% CI: 1.18-1.28, P<0.0001) for overall survival (OS). CTC count of ≥15 or ≥50 was significantly associated with an increased risk of progression (CTC ≥15: HR 3.20, 95% CI: 2.50-4.09, P<0.001; CTC ≥50: HR 2.56, 95% CI: 2.01-3.25, P<0.001) and an increased risk of death (CTC ≥15: HR 2.90, 95% CI: 2.28-3.70, P<0.001; CTC ≥50: HR 2.47, 95% CI: 1.95-3.13, P<0.001). There was no significant inter-centre heterogeneity observed. Addition of CTC count to clinico-pathological models as a continuous log-transformed variable, offers further prognostic value (both likelihood ratio P<0.001 for OS and PFS). Conclusions: Higher pre-treatment CTC counts are a negative independent prognostic factor in SCLC when considered as a continuous variable or dichotomised counts of ≥15 or ≥50. Incorporating CTC counts, as a continuous variable, improves clinic-pathological prognostic models.Citation
Foy V, Lindsay CR, Carmel A, Fernandez-Gutierrez F, Krebs MG, Priest L, et al. EPAC-lung: European pooled analysis of the prognostic value of circulating tumour cells in small cell lung cancer. Transl Lung Cancer Res. 2021 Apr;10(4):1653–65.Journal
Translational Lung Cancer ResearchDOI
10.21037/tlcr-20-1061PubMed ID
34012782Additional Links
https://dx.doi.org/10.21037/tlcr-20-1061Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.21037/tlcr-20-1061
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