Prognostic Role of Circulating Tumor Cell Trajectories in Metastatic Colorectal Cancer

Valentina Magri; Luca Marino; Chiara Nicolazzo; Angela Gradilone; Gianluigi De Renzi; Michela De Meo; Orietta Gandini; Arianna Sabatini; Daniele Santini; Enrico Cortesi; Paola Gazzaniga

doi:10.3390/cells12081172

Prognostic Role of Circulating Tumor Cell Trajectories in Metastatic Colorectal Cancer

Cells. 2023 Apr 16;12(8):1172. doi: 10.3390/cells12081172.

Affiliations

¹ Department of Pathology, Oncology and Radiology, Sapienza University of Rome, 00161 Rome, Italy.
² Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy.
³ Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy.

Abstract

Background: A large amount of evidence from clinical studies has demonstrated that circulating tumor cells are strong predictors of outcomes in many cancers. However, the clinical significance of CTC enumeration in metastatic colorectal cancer is still questioned. The aim of this study was to evaluate the clinical value of CTC dynamics in mCRC patients receiving first-line treatments.

Materials and methods: Serial CTC data from 218 patients were used to identify CTC trajectory patterns during the course of treatment. CTCs were evaluated at baseline, at a first-time point check and at the radiological progression of the disease. CTC dynamics were correlated with clinical endpoints.

Results: Using a cut-off of ≥1 CTC/7.5 mL, four prognostic trajectories were outlined. The best prognosis was obtained for patients with no evidence of CTCs at any timepoints, with a significant difference compared to all other groups. Lower PFS and OS were recognized in group 4 (CTCs always positive) at 7 and 16 months, respectively.

Conclusions: We confirmed the clinical value of CTC positivity, even with only one cell detected. CTC trajectories are better prognostic indicators than CTC enumeration at baseline. The reported prognostic groups might help to improve risk stratification, providing potential biomarkers to monitor first-line treatments.

Keywords: CellSearch®; circulating tumor cell trajectories; circulating tumor cells; liquid biopsy; metastatic colorectal cancer; precision medicine; prognostic and predictive biomarkers.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers, Tumor
Colorectal Neoplasms* / pathology
Disease-Free Survival
Humans
Neoplastic Cells, Circulating* / pathology
Prognosis

Substances

Biomarkers, Tumor

Grants and funding

This study was funded by Sapienza University of Rome (protocol number C26A09LB5J). The funding sources had no role in the study design or in the collection, analysis or interpretation of data.