BackgroundSurgery is the treatment of choice for patients with non-small cell lung cancer (NSCLC) stages I-IIIA. However, more than 20% of these patients develop recurrence and die due to their disease. The release of tumor cells into peripheral blood (CTCs) is one of the main causes of recurrence of cancer. The objectives of this study are to identify the prognostic value of the presence and characterization of CTCs in peripheral blood in patients undergoing radical resection for NSCLC.Patients and Methods56 patients who underwent radical surgery for previously untreated NSCLC were enrolled in this prospective study. Peripheral blood samples for CTC analysis were obtained before and one month after surgery. In addition CTCs were phenotypically characterized by epidermal growth factor receptor (EGFR) expression.Results51.8% of the patients evaluated were positive with the presence of CTCs at baseline. A decrease in the detection rate of CTCs was observed in these patients one month after surgery (32.1%) (p = 0.035). The mean number of CTCs was 3.16 per 10 ml (range 0–84) preoperatively and 0.66 (range 0–3) in postoperative determination. EGFR expression was found in 89.7% of the patients at baseline and in 38.9% patients one month after surgery. The presence of CTCs after surgery was significantly associated with early recurrence (p = 0.018) and a shorter disease free survival (DFS) (p = .008). In multivariate analysis CTC presence after surgery (HR = 5.750, 95% CI: 1.50–21.946, p = 0.010) and N status (HR = 0.296, 95% CI: 0.091–0.961, p = 0.043) were independent prognostic factors for DFS.ConclusionCTCs can be detected and characterized in patients undergoing radical resection for non-small cell lung cancer. Their presence might be used to identify patients with increased risk of early recurrence.

The first episode of lung surgery for pulmonary metastases of CRC was associated with very low mortality and reoperation rates (<1%). The postoperative morbidity rate was 16%. Independent risk factors of postoperative morbidity were major lung resection and respiratory and/or cardiovascular co-morbidity. Video-assisted surgery showed a protective effect.

Detection of CTCs 1 month after radical resection might be a useful marker to predict early recurrence in Stage I-III NSCLC. The SUVmax value of the primary tumour on preoperative PET scans was associated with the presence of CTC 1 month after the operation.

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Methods: CRISP (NCT02622581) is a prospective, observational, open, multicentre, interdisciplinary clinical research platform that collects data on all (sequential) treatments, patient and tumour chr, biomarker testing, clinical and patient-reported out in w180 hospitals and practices in Germany. Currently 6300+ pts were recruited, who will be followed until death or end of project. Data from 493 pts with PD-L1 TPS50% recruited between 12/2015 and 06/2019 and receiving CPI as 1 st -line treatment was analysed. Pts were deemed se if they had the following chr: ECOG¼0-1, Stage IV, no brain metastases, no HIV or second tumour and no prior (neo-)adjuvant therapies.Results: Of 473 analysed pts 191 pts were potentially se in reflection of inclusion criteria for clinical trials KEYNOTE 42 and 24, 282 pts were n-se representing the realworld pts population. Although both groups are similar in age (median 68 years, both) and CR/PR rates were comparable (1%[se] vs. 2%[n-se] and 21% vs. 22%) as well as rates of stopped treatments because of toxicity (10%, both), potentially se pts. had a longer PFS (10.

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