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W. Guo
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MA08 - Treatment Monitoring in Advanced NSCLC (ID 386)
- Event: WCLC 2016
- Type: Mini Oral Session
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:R. Perez-Soler, T. Reungwetwattana
- Coordinates: 12/06/2016, 11:00 - 12:30, Lehar 3-4
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MA08.07 - Prospective Sequential Counts of Total CTC or cKIT+CTC in Advanced NSCLC with 1st Line Chemotherapy (POLICE) (ID 5857)
11:42 - 11:48 | Author(s): W. Guo
- Abstract
- Presentation
Background:
Circulating tumor cells (CTCs) have been reported prognostic and predictive in non-small cell lung cancer (NSCLC) and a few of other cancer types. In 1[st] line setting, whether EPCAM[+]CK[+]CD45[-] CTC and/or stem cell-like cKIT[+]EPCAM[+ ]CK[+]CD45[-] CTC enumeration and dynamic changes can be prognostic and/or predictive to standard chemotherapy need further investigation in Chinese patients with NSCLC.
Methods:
A prospective study on the CTC enumeration in advanced NSCLC with 1st line chemotherapy (POLICE) was started by China Thoracic Oncology Group (CTONG). Patients with NSCLC naïve for systemic regimens were enrolled since August 2013. CTCs were detected by Cell Search Platform and identified as positive for EPCAM[+]CK[+]CD45[-] phenotype. CD117 (cKIT) marker was added to test the frequency of stem cell-like cKIT[+]EPCAM[+]CK[+]CD45[- ]CTCs. Primary endpoints were CTC counts and its correlation with first line therapy.
Results:
Totally 180 patients were enrolled. In 174 case total CTC and cKIT[+]CTC positive (cutoff >=1) rates were 38.5% (67/172) vs 14.3% (24/168), 21.8% (31/142) vs 6.3% (9/142), 13.7% (13/95) vs 6.4% (6/94) and 40.4% (38/94) vs 15.0% (13/93) at time-points of baseline, after first-cycle-chemo, after four-cycles-chemo and disease progression. At time immediately after first-cycle-chemo, patients in CTC=0 group got statistically higher ORR (29.0% VS 7.1%, P=0.017) and DCR (74.2% VS 42.9%, P=0.002) than in CTC>=1 group. At time after four-cycles-chemo, patients in CTC=0 group got statistically higher DCR (88.3% VS 58.3%, P=0.026) than in CTC>=1 group. At time either after first-cycle-chemo or after four-cycles-chemo, patients in CTC>=1 group got worse PFS (5.7m VS 4.0m, P=0.025; 6.3m VS 4.0m, P=0.001 ) than in CTC=0 group. At time after first-cycle-chemo, patients in groups cKIT[+]CTC>=1 and cKIT[-]CTC>=1 got worse PFSs (3.1m vs 4.0m vs 5.7m, P=0.001) and worse DCRs (44.4% vs 42.1% vs 73.9%, P=0.009) than in CTC=0 group. For 142 patients categorized into three groups of dynamic CTC decrease (17), CTC unchanged (82), and CTC increase (43), there were significant differences in terms of DCR (71.8% vs 71.6% vs 33.3%, P=0.018) and PFS (5.2m vs 5.6m vs 3.1m, P=0.037).
Conclusion:
In first line setting of advanced NSCLC, at time-points after first-cycle-chemo other than baseline, total CTC or cKIT[+]CTC counts could be predictive for worse DCR or PFS. CTC increase from baseline to after-first-cycle-chemo might be a strong signal for the inefficacy of first line chemotherapy in the NSCLC patients.
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P2.03b - Poster Session with Presenters Present (ID 465)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03b-041 - Cerebrospinal Fluid Tumor Cells for Diagnosis of Leptomeningeal Metastases in Non-Small Cell Lung Cancer (ID 4479)
14:30 - 14:30 | Author(s): W. Guo
- Abstract
Background:
The diagnosis of leptomeningeal metastases (LM) relied on tumor cells found in cerebrospinal fluid (CSF) and/or typical magnetic resonance imaging (MRI) findings, but both lack sensitivity. The CellSearch Assay™ had been validated to detect CTCs for follow-ups of cancer patients, and we adapted it to identify CSF tumor cells (CSFTCs) in non-small cell lung cancer (NSCLC) with suspected LM, and moreover detected their gene statuses of epidermal growth factor receptor (EGFR).
Methods:
Twenty-one NSCLC patients with suspicious LM had CSF analyzed through both traditional Thinprep cytologic test (TCT) and CellSearch, and peripheral blood were detected for circulating tumor cells (CTCs) in fourteen patients. The statuses of EGFR were tested in primary tissues of all twenty-one patients and in CSFTCs of eight patients.
Results:
All twenty-one patients were identified as LM, CSFTCs were captured by CellSearch in twenty patients (median 969 CSFTCs/ 7.5 mL, range: 27-14888), while CTCs were captured in only five patients (median 2 CTCs/7.5 mL, range: 2-4), which were much lower than CSFTCs. The sensitivity of CellSearch was 95.2%, while that of TCT from the same CSF puncture was 57.1%, and that of MRI was 52.4%, and that of combined MRI and TCT was 90.5%. Moreover, the specificity of CSFTCs was 100%. Among eight patients with EGFR tested in CSFTCs, six patients matched with primary tissues and resistant gene T790M was identified in two cases.Figure 1
Conclusion:
Cerebrospinal fluid tumor cells could be more sensitive and effective to diagnose LM, and may serve as the potential way of liquid biopsy for EGFR mutation in NSCLC with LM.
