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dc.contributor.authorFoy, Victoria
dc.contributor.authorLindsay, Colin R
dc.contributor.authorCarmel, A.
dc.contributor.authorFernandez-Gutierrez, Fabiola
dc.contributor.authorKrebs, Matthew G
dc.contributor.authorPriest, Lynsey
dc.contributor.authorCarter, Mathew
dc.contributor.authorGroen, H. J. M.
dc.contributor.authorHiltermann, T. J. N.
dc.contributor.authorde Luca, A.
dc.contributor.authorFarace, F.
dc.contributor.authorBesse, B.
dc.contributor.authorTerstappen, L.
dc.contributor.authorRossi, E.
dc.contributor.authorMorabito, A.
dc.contributor.authorPerrone, F.
dc.contributor.authorRenehan, Andrew G
dc.contributor.authorFaivre-Finn, Corinne
dc.contributor.authorNormanno, N.
dc.contributor.authorDive, Caroline
dc.contributor.authorBlackhall, Fiona H
dc.contributor.authorMichiels, S.
dc.date.accessioned2021-07-19T10:28:39Z
dc.date.available2021-07-19T10:28:39Z
dc.date.issued2021en
dc.identifier.citationFoy 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.en
dc.identifier.pmid34012782en
dc.identifier.doi10.21037/tlcr-20-1061en
dc.identifier.urihttp://hdl.handle.net/10541/624064
dc.description.abstractBackground: 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.en
dc.language.isoenen
dc.relation.urlhttps://dx.doi.org/10.21037/tlcr-20-1061en
dc.titleEPAC-lung: European pooled analysis of the prognostic value of circulating tumour cells in small cell lung canceren
dc.typeArticleen
dc.contributor.departmentCancer Research UK Manchester Institute Cancer Biomarker Centre, Cancer Research UK Manchester Institute, University of Manchester, Manchester, Uen
dc.identifier.journalTranslational Lung Cancer Researchen
dc.description.noteen]
refterms.dateFOA2021-07-26T11:06:13Z


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