Circulating tumor cell analysis in locally advanced and metastatic squamous cell carcinoma of the head and neck

Abstract

Background: Circulating tumors cells (CTCs) are considered an early step towards metastasis and have been linked to poor prognosis in several types of cancer. CTCs in squamous cell carcinoma of the head and neck (SCCHN) have an unclear role. Methods: In this prospective study, patients with locally advanced or metastatic SCCHN had CTC counts assessed before starting systemic treatment using the Cel-lSearch System. Select cases also had sequential CTC evaluation. Presence of CTCs was correlated with patient characteristics and outcomes. Results: Forty-eight patients enrolled, and 36 had evaluable clinical data and baseline CTC counts. Twenty-five patients had locally advanced disease (LAD) and 11 had metastatic disease. ≥1 CTCs were detected in six patients with LAD (24%) and four with metastatic disease (36%). On univariate analysis, smoking was associated with CTCs. Conclusion: CTCs are not associated with prognosis in patients with LAD and metastatic disease; however, they are present in this patient population, and ≥1 CTCs is associated with a history of smoking.

Multiparametric Phenotyping of Circulating Tumor Cells for Analysis of Therapeutic Targets, Oncogenic Signaling Pathways and DNA Repair Markers

“…Without applying a cut–off for CTC positivity, the specificity of our ISX protocol was 91%, where 1 of 11 samples tested positive in a blinded analysis of healthy donor blood samples. While the optimal cut–off for definition of a poor–outcome group has yet to be established in HNSCC [ 5 , 18 ], a cut–off of ≥3 CTCs/7.5 mL blood has been demonstrated to identify colon cancer patients with poor outcomes [ 3 ]. Using this threshold, specificity increased to 100% for our CTC detection protocol.…”

Effects of Red Blood Cell Transfusions on Distant Metastases of Oral Squamous Cell Carcinomas

“…Circulating tumor cells (CTC) are present in the bloodstream in the perioperative cancer surgery setting in numerous entities and usually correlate with tumor size, nodal infiltration, or metastatic spread [ 44 , 45 ] and can be likewise detected in the bone marrow of OSCC patients [ 46 ]. This condition is the foundation for various liquid biopsy methods aiming at early detection as well as for monitoring the course and creating prediction models of malignant diseases [ 47 , 48 , 49 ].…”

Liquid Biopsy in Squamous Cell Carcinoma of the Esophagus and of the Head and Neck

“…Two excellent recent publications, a systematic review and a meta-analysis have addressed the utility of CTCs in diagnostic and prognosis of HNSCC (17,21). Most representative papers on this subject consist of nine prospective cohort studies and one retrospective cohort study (5,(22)(23)(24)(25)(26)(27)(28)(29)(30). The studies are heterogeneous in terms of disease staging, including either patients diagnosed in stages I-IV or only advanced disease cases (stages III-IV).…”