Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer

S. J. Cohen; C. J. A. Punt; N. Iannotti; B. H. Saidman; K. D. Sabbath; N. Y. Gabrail; J. Picus; M. A. Morse; E. Mitchell; M. C. Miller; G. V. Doyle; H. Tissing; L. W. M. M. Terstappen; N. J. Meropol

doi:https://doi.org/10.1093/annonc/mdn786

Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer

S. J. Cohen, C. J. A. Punt, N. Iannotti, B. H. Saidman, K. D. Sabbath, N. Y. Gabrail, J. Picus, M. A. Morse, E. Mitchell, M. C. Miller, G. V. Doyle, H. Tissing, L. W. M. M. Terstappen, N. J. Meropol

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Abstract

We demonstrated that circulating tumor cell (CTC) number at baseline and follow-up is an independent prognostic factor in metastatic colorectal cancer (mCRC). This analysis was undertaken to explore whether patient and treatment characteristics impact the prognostic value of CTCs. CTCs were enumerated with immunomagnetic separation from the blood of 430 patients with mCRC at baseline and on therapy. Patients were stratified into unfavorable and favorable prognostic groups based on CTC levels of > or = 3 or <3 CTCs/7.5 ml, respectively. Subgroups were analyzed by line of treatment, liver involvement, receipt of oxaliplatin, irinotecan, or bevacizumab, age, and Eastern Cooperative Oncology Group performance status (ECOG PS). Seventy-one percent of deaths have occurred. Median follow-up for living patients is 25.8 months. For all patients, progression-free survival (PFS) and overall survival (OS) for unfavorable compared with favorable baseline CTCs is shorter (4.4 versus 7.8 m, P = 0.004 for PFS; 9.4 versus 20.6 m, P <0.0001 for OS). In all patient subgroups, unfavorable baseline CTC was associated with inferior OS (P <0.001). In patients receiving first- or second-line therapy (P = 0.003), irinotecan (P = 0.0001), having liver involvement (P = 0.002), >/=65 years (P = 0.0007), and ECOG PS of zero (P = 0.04), unfavorable baseline CTC was associated with inferior PFS. Baseline CTC count is an important prognostic factor within specific subgroups defined by treatment or patient characteristics

Original language	English
Pages (from-to)	1223-1229
Journal	Annals of Oncology
Volume	20
Issue number	7
DOIs	https://doi.org/10.1093/annonc/mdn786
Publication status	Published - 2009

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Cohen, S. J., Punt, C. J. A., Iannotti, N., Saidman, B. H., Sabbath, K. D., Gabrail, N. Y., Picus, J., Morse, M. A., Mitchell, E., Miller, M. C., Doyle, G. V., Tissing, H., Terstappen, L. W. M. M., & Meropol, N. J. (2009). Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer. Annals of Oncology, 20(7), 1223-1229. https://doi.org/10.1093/annonc/mdn786

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title = "Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer",

abstract = "We demonstrated that circulating tumor cell (CTC) number at baseline and follow-up is an independent prognostic factor in metastatic colorectal cancer (mCRC). This analysis was undertaken to explore whether patient and treatment characteristics impact the prognostic value of CTCs. CTCs were enumerated with immunomagnetic separation from the blood of 430 patients with mCRC at baseline and on therapy. Patients were stratified into unfavorable and favorable prognostic groups based on CTC levels of > or = 3 or <3 CTCs/7.5 ml, respectively. Subgroups were analyzed by line of treatment, liver involvement, receipt of oxaliplatin, irinotecan, or bevacizumab, age, and Eastern Cooperative Oncology Group performance status (ECOG PS). Seventy-one percent of deaths have occurred. Median follow-up for living patients is 25.8 months. For all patients, progression-free survival (PFS) and overall survival (OS) for unfavorable compared with favorable baseline CTCs is shorter (4.4 versus 7.8 m, P = 0.004 for PFS; 9.4 versus 20.6 m, P <0.0001 for OS). In all patient subgroups, unfavorable baseline CTC was associated with inferior OS (P <0.001). In patients receiving first- or second-line therapy (P = 0.003), irinotecan (P = 0.0001), having liver involvement (P = 0.002), >/=65 years (P = 0.0007), and ECOG PS of zero (P = 0.04), unfavorable baseline CTC was associated with inferior PFS. Baseline CTC count is an important prognostic factor within specific subgroups defined by treatment or patient characteristics",

author = "Cohen, {S. J.} and Punt, {C. J. A.} and N. Iannotti and Saidman, {B. H.} and Sabbath, {K. D.} and Gabrail, {N. Y.} and J. Picus and Morse, {M. A.} and E. Mitchell and Miller, {M. C.} and Doyle, {G. V.} and H. Tissing and Terstappen, {L. W. M. M.} and Meropol, {N. J.}",

year = "2009",

doi = "https://doi.org/10.1093/annonc/mdn786",

language = "English",

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TY - JOUR

T1 - Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer

AU - Cohen, S. J.

AU - Punt, C. J. A.

AU - Iannotti, N.

AU - Saidman, B. H.

AU - Sabbath, K. D.

AU - Gabrail, N. Y.

AU - Picus, J.

AU - Morse, M. A.

AU - Mitchell, E.

AU - Miller, M. C.

AU - Doyle, G. V.

AU - Tissing, H.

AU - Terstappen, L. W. M. M.

AU - Meropol, N. J.

PY - 2009

Y1 - 2009

N2 - We demonstrated that circulating tumor cell (CTC) number at baseline and follow-up is an independent prognostic factor in metastatic colorectal cancer (mCRC). This analysis was undertaken to explore whether patient and treatment characteristics impact the prognostic value of CTCs. CTCs were enumerated with immunomagnetic separation from the blood of 430 patients with mCRC at baseline and on therapy. Patients were stratified into unfavorable and favorable prognostic groups based on CTC levels of > or = 3 or <3 CTCs/7.5 ml, respectively. Subgroups were analyzed by line of treatment, liver involvement, receipt of oxaliplatin, irinotecan, or bevacizumab, age, and Eastern Cooperative Oncology Group performance status (ECOG PS). Seventy-one percent of deaths have occurred. Median follow-up for living patients is 25.8 months. For all patients, progression-free survival (PFS) and overall survival (OS) for unfavorable compared with favorable baseline CTCs is shorter (4.4 versus 7.8 m, P = 0.004 for PFS; 9.4 versus 20.6 m, P <0.0001 for OS). In all patient subgroups, unfavorable baseline CTC was associated with inferior OS (P <0.001). In patients receiving first- or second-line therapy (P = 0.003), irinotecan (P = 0.0001), having liver involvement (P = 0.002), >/=65 years (P = 0.0007), and ECOG PS of zero (P = 0.04), unfavorable baseline CTC was associated with inferior PFS. Baseline CTC count is an important prognostic factor within specific subgroups defined by treatment or patient characteristics

AB - We demonstrated that circulating tumor cell (CTC) number at baseline and follow-up is an independent prognostic factor in metastatic colorectal cancer (mCRC). This analysis was undertaken to explore whether patient and treatment characteristics impact the prognostic value of CTCs. CTCs were enumerated with immunomagnetic separation from the blood of 430 patients with mCRC at baseline and on therapy. Patients were stratified into unfavorable and favorable prognostic groups based on CTC levels of > or = 3 or <3 CTCs/7.5 ml, respectively. Subgroups were analyzed by line of treatment, liver involvement, receipt of oxaliplatin, irinotecan, or bevacizumab, age, and Eastern Cooperative Oncology Group performance status (ECOG PS). Seventy-one percent of deaths have occurred. Median follow-up for living patients is 25.8 months. For all patients, progression-free survival (PFS) and overall survival (OS) for unfavorable compared with favorable baseline CTCs is shorter (4.4 versus 7.8 m, P = 0.004 for PFS; 9.4 versus 20.6 m, P <0.0001 for OS). In all patient subgroups, unfavorable baseline CTC was associated with inferior OS (P <0.001). In patients receiving first- or second-line therapy (P = 0.003), irinotecan (P = 0.0001), having liver involvement (P = 0.002), >/=65 years (P = 0.0007), and ECOG PS of zero (P = 0.04), unfavorable baseline CTC was associated with inferior PFS. Baseline CTC count is an important prognostic factor within specific subgroups defined by treatment or patient characteristics

U2 - https://doi.org/10.1093/annonc/mdn786

DO - https://doi.org/10.1093/annonc/mdn786

M3 - Article

C2 - 19282466

SN - 0923-7534

VL - 20

SP - 1223

EP - 1229

JO - Annals of Oncology

JF - Annals of Oncology

IS - 7

ER -