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Circulating tumour cells early predict progression-free and overall survival in advanced colorectal cancer patients treated with chemotherapy and targeted agents
Annals of Oncology, 11/02/09

Tol J et al. – The CTC count before and during treatment independently predicts PFS and OS in ACC patients treated with chemotherapy plus targeted agents and provides additional information to CT imaging.

Methods

CTC determined at baseline and different time points during treatment
Patients stratified into low (less than three CTC per 7.5 ml of blood) or high CTC (three or more CTC per 7.5 ml of blood)

Results

467 patients assessable for CTC analysis
129 patients (29%) with high baseline CTC had significantly decreased PFS [hazard ratio (HR) 1.5] and overall survival (OS; HR 2.2) compared with 322 patients with low baseline CTC
Difference remained statistically significant during treatment
Sensitivity and specificity of high CTC at baseline for prediction of progressive disease on CT imaging 16.7% and 70.1%, respectively, and of high CTC at 1–2 weeks after start of treatment 20.0% and 95.1%, respectively
Combined analysis of CTC and CT imaging provided a more accurate outcome assessment than either modality alone

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