Cerebrospinal fluid circulating tumor cells: a novel tool to diagnose leptomeningeal metastases from epithelial tumors

Abstract

We defined ≥1 CSF-CTC/mL as the optimal cutoff for diagnosis of LM. CSF-CTC enumeration through RCCT is a robust tool to diagnose LM and should be considered in the routine LM workup in solid tumor patients.

Leptomeningeal disease in melanoma patients: An update to treatment, challenges, and future directions

“…Limited by several technical constraints, previous somewhat coarse analyses provided limited diagnostic information or pathophysiologic insight. Modern, highly granular analytic approaches to CSF, or “liquid biopsies,” have the potential to greatly improve diagnostic sensitivity of LMD, guide treatment decisions, and drive discovery (Boire et al, , ; Lin et al, ; Miller et al, ). There are two main liquid biopsy approaches currently in use in LMD: circulating tumor cell analysis (CTCs) and cell‐free tumor DNA sequencing (ctDNA); these are reviewed in detail below.…”

“…New semi‐automated cell assays have been applied with some success to melanoma as well as other solid tumors for the purpose of diagnosing LMD (Le Rhun, Tu, et al, ; Lin et al, , #1447). In the largest cohort ( n = 95, 36 breast, 31 lung, 28 others) to date, a cutoff of ≥1 CSF‐CTC/ml provided the best threshold to diagnose LMD, achieving a sensitivity of 93%, specificity of 95%, positive predictive value 90%, and negative predictive value 97% (Lin et al, ). Other methods, such as flow cytometry, have proved disappointing due to inconsistent surface marker expression.…”

Clinical Presentation, Diagnosis, and Radiological Findings of Neoplastic Meningitis

“…The rates of sensitivity were 95% for CSF CTCs compared with 81% for CSF cytology alone and 62% for MRI alone. 110 The rate of specificity was 83%. 110 Thus, this method had superior diagnostic performance when compared with CSF cytology or MRI.…”

“…110 The rate of specificity was 83%. 110 Thus, this method had superior diagnostic performance when compared with CSF cytology or MRI.…”

“…108 It is worth mentioning that new technologies to collect CSF circulating cancer cells are being evaluated because they have been shown to perform better than cytology in detecting neoplastic meningitis in patients with lung cancer. 109 Lin et al 110 presented the validation of CSF circulating tumor cells (CTCs) to diagnose neoplastic meningitis from epithelial tumors in patients suspected of having the disease. MRI and CSF analyses were performed using conventional cytology and enumeration of CSF CTCs for all study participants.…”