Platelet cloaking of circulating tumour cells in patients with metastatic prostate cancer: Results from ExPeCT, a randomised controlled trial

PLoS One. 2020 Dec 18;15(12):e0243928. doi: 10.1371/journal.pone.0243928. eCollection 2020.

Abstract

Background: Circulating tumour cells (CTCs) represent a morphologically distinct subset of cancer cells, which aid the metastatic spread. The ExPeCT trial aimed to examine the effectiveness of a structured exercise programme in modulating levels of CTCs and platelet cloaking in patients with metastatic prostate cancer.

Methods: Participants (n = 61) were randomised into either standard care (control) or exercise arms. Whole blood was collected for all participants at baseline (T0), three months (T3) and six months (T6), and analysed for the presence of CTCs, CTC clusters and platelet cloaking. CTC data was correlated with clinico-pathological information.

Results: Changes in CTC number were observed within group over time, however no significant difference in CTC number was observed between groups over time. Platelet cloaking was identified in 29.5% of participants. A positive correlation between CTC number and white cell count (WCC) was observed (p = 0.0001), in addition to a positive relationship between CTC clusters and PSA levels (p = 0.0393).

Conclusion: The presence of platelet cloaking has been observed in this patient population for the first time, in addition to a significant correlation between CTC number and WCC.

Trial registration: ClincalTrials.gov identifier NCT02453139.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers, Tumor / blood*
  • Blood Platelets / metabolism*
  • Blood Platelets / pathology
  • Cell Count
  • Humans
  • Male
  • Neoplasm Metastasis
  • Neoplastic Cells, Circulating / metabolism*
  • Neoplastic Cells, Circulating / pathology
  • Prognosis
  • Prostatic Neoplasms / blood*
  • Prostatic Neoplasms / genetics
  • Prostatic Neoplasms / pathology

Substances

  • Biomarkers, Tumor

Associated data

  • ClinicalTrials.gov/NCT02453139

Grants and funding

This research was sponsored by Cancer Trials Ireland. Author SF received funding from the World Cancer Research Fund (https://www.wcrf.org/; grant number 2012/1003). The funders had no role in the collection of specimens or analysis of data throughout the study duration, and had no role in preparation or review of this manuscript for publication.