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• 10583

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  P1.06 - Poster Session 1 - Prognostic and Predictive Biomarkers (ID 161)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Biology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10589

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    P1.06-006 - Prognostic value of serial peripheral circulating tumour cells (CTC) evaluation in patients with advanced non-small cell lung cancer (NSCLC) during first line treatment. (ID 841)

    09:30 - 09:30  |  Author(s): V. De La Orden
    • Abstract

    Background
    Treatment strategy in lung cancer is lack of surrogate markers that may improve the clinical management in such an aggressive and deadliest tumour. Recently, CTC detection and characterization has been suggested as a promising and valuable outcome biomarker that is beginning to be elucidated in this context. The study investigates whether CTC reduction along treatment has a prognostic significance in previously untreated patients with advanced NSCLC receiving chemotherapy.

    Methods
    Patients with histologically confirmed stage III or IV NSCLC and suitable for chemotherapy treatment were selected for the study irrespective of other baseline characteristics. From each patient, two peripheral blood samples for CTC analysis were collected at baseline and concomitantly with first radiological evaluation, after three cycles of chemotherapy. CTC expressing EpCAM were detected in the semiautomated platform; the CellSearch® system.

    Results
    In this single institution prospective study, 25 consecutive patients were included between April 2011 and January 2013. The patients had a median age of 67 years (range 41-80), most were former or current smokers (60% and 32%, respectively), had ECOG 1 (80%), adenocarcinoma subtype (80%) and stage IV tumour at diagnosis (84%). First line platinum-containing chemotherapy was combined with antiangiogenics in 64% and with antifolates in 36% of patients. After 34 months of follow up, the median overall survival for the whole population was 10.9 months (95% IC 6.9-15 months). A non-significant survival benefit was identified in the group of patients for whom a reduction in CTC enumeration was achieved (N=12), in comparison to those with equal or greater number of CTC detected (N=13) between the first and second blood samples collected [11.2 months (95%IC 9.07 – 13.4) vs 7.2 months (95% IC 4.9 – 9.5); p=0.44] (figure 1). However, progression free survival was similar in both groups of patients (5.9 months vs 5.6 months, respectively). Figure 1 Figure 1. Kaplan-Meier curves for overall survival (OS) of patients with a reduction in the number of CTC (R-CTC) versus patients with equal or greater number of CTC (NR-CTC) detected in peripheral blood samples during chemotherapy treatment.

    Conclusion
    CTC serial isolation along treatment is a non-invasive tool that shows an encouraging prognostic value in advanced non-small cell lung cancer. Those findings strengthen the introduction of outcome markers in treatment decisions in this setting, but warrants further investigation for its validation in larger studies.