循环肿瘤细胞作为复发性或转移性头颈部鳞状细胞癌的预后因素：CIRCUTEC 前瞻性研究。

Circulating Tumor Cells as a Prognostic Factor in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: The CIRCUTEC Prospective Study.

机构信息

Department of Head Neck Cancer and Laryngology, University Medical Center of Montpellier, Montpellier, France.

Laboratory of Rare Human Circulating Cells (LCCRH), University Medical Center of Montpellier, Montpellier, France.

出版信息

Clin Chem. 2019 Oct;65(10):1267-1275. doi: 10.1373/clinchem.2019.305904. Epub 2019 Aug 6.

DOI:10.1373/clinchem.2019.305904

PMID:31387885

Abstract

BACKGROUND

This prospective multicenter study evaluated the prognostic value of circulating tumor cells (CTCs) in relapsing nonoperable or metastatic head and neck squamous cell carcinoma (rHNSCC) treated by chemotherapy and cetuximab.

METHODS

In 65 patients suitable for analyses, peripheral blood was taken at day 0 (D) D, and D of treatment for CTC detection by CellSearch, EPISPOT, and flow cytometry (FCM). Progression-free survival (PFS) was assessed with the Kaplan-Meier method and compared with the log-rank test ( < 0.05).

RESULTS

At D, CTCs were detected with EPISPOT, CellSearch, and FCM in 69% (45/65), 21% (12/58), and 11% (7/61) of patients, respectively. In the patients tested with all 3 methods, EPISPOT identified 92% (36/39), 92% (35/38), and 90% (25/28) of all positive samples at D, D, and D, respectively. Median PFS time was significantly lower in () patients with increasing or stable CTC counts (36/54) from D to D with EPISPOT (3.9 vs 6.2 months; 95% CI, 5.0-6.9; = 0.0103) and () patients with ≥1 CTC detected with EPISPOT or CellSearch (37/51) ( = 0.0311), EPISPOT or FCM (38/54) ( = 0.0480), and CellSearch or FCM (11/51) ( = 0.0005) at D.

CONCLUSIONS

CTCs can be detected before and during chemotherapy in patients with rHNSCC. D-D CTC kinetics evaluated with EPISPOT are associated with the response to treatment. This study indicates that CTCs can be used as a real-time liquid biopsy to monitor the early response to chemotherapy in rHNSCC.

CLINICALTRIALSGOV IDENTIFIER

NCT02119559.

摘要

背景

本前瞻性多中心研究评估了循环肿瘤细胞（CTC）在接受化疗和西妥昔单抗治疗的复发性不可手术或转移性头颈部鳞状细胞癌（rHNSCC）患者中的预后价值。

方法

在 65 例适合分析的患者中，在治疗的第 0 天（D）、D 和 D 时采集外周血，通过 CellSearch、EPISPOT 和流式细胞术（FCM）检测 CTC。使用 Kaplan-Meier 方法评估无进展生存期（PFS），并与对数秩检验进行比较（<0.05）。

结果

在 D 时，分别通过 EPISPOT、CellSearch 和 FCM 在 69%（45/65）、21%（12/58）和 11%（7/61）的患者中检测到 CTC。在接受所有 3 种方法检测的患者中，EPISPOT 在 D、D 和 D 时分别识别了 92%（36/39）、92%（35/38）和 90%（25/28）的所有阳性样本。通过 EPISPOT 从 D 到 D 时，CTC 计数增加或稳定的患者（36/54）的中位 PFS 时间明显降低（3.9 个月对 6.2 个月；95%CI，5.0-6.9；=0.0103），并且在 EPISPOT 或 CellSearch 检测到≥1 个 CTC 的患者（37/51）（=0.0311）、EPISPOT 或 FCM（38/54）（=0.0480）和 CellSearch 或 FCM（11/51）（=0.0005）在 D 时，PFS 时间明显降低。