Prospective Trial of Circulating Tumor Cells as a Biomarker for Early Detection of Recurrence in Patients with Locally Advanced Non–Small Cell Lung Cancer Treated with Chemoradiation Therapy

Chinniah, C.; Aguarin, Louise; Cheng, Phillip; DeCesaris, C.; Cutillo, Alicia; Berman, Abigail T.; Frick, Melissa A.; Levin, William P.; Cengel, Keith A.; Hahn, Stephen M.; Dorsey, Jay F.; Kao, Gary D.; Simone, Charles B.

doi:10.1016/j.ijrobp.2017.01.039

Cited by 5 publications

(4 citation statements)

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“…9 In the future, the detection of circulating tumour cells or tumour DNA could facilitate early identification of residual or recurrent disease. 27,28 In addition, improved imaging techniques, such as PET/MRI, combined with functional tests, like diffusion-weighted imaging, could further improve detection of recurrent tumour and distinguish it from pseudoprogression or fibrotic changes after CRT. 29…”

Section: Discussionmentioning

confidence: 99%

Salvage surgery for recurrent or persistent tumour after radical (chemo)radiotherapy for locally advanced non-small cell lung cancer: a systematic review

Dickhoff

Otten

Heymans³

et al. 2018

Ther Adv Med Oncol

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Background:Once recurrent or persistent locoregional tumour after radical chemoradiotherapy (CRT) for non-small cell lung cancer (NSCLC) is identified, few curative-intent treatment options are available. Selected patients might benefit from surgical salvage. We performed a systematic review of the available literature for this emerging treatment option.Methods:A systematic literature search was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Publications about persistent or (locoregional) recurrent disease after radical/definitive CRT for locally advanced non-small cell lung cancer were identified.Results:Eight full papers were found, representing 158 patients. All were retrospective series and data were heterogeneous: definition and indication for salvage surgery varied and the median time from radiotherapy to surgery was 4.1–33 months. Complete resection (R0) was achieved in 85–100%, with vital tumour in 61–100%. A large number of pneumonectomies were performed, and additional structures were often resected. Where reported, 90-day mortality was 0–11.4%. Reported survival metrics varied but included median overall survival 9–46 months and 5-year survival 20–75%.Conclusion:There are limited, low-level, heterogeneous data in support of salvage surgery after radical CRT. Based on this, perioperative mortality appears acceptable and long-term survival is possible in (highly) selected patients. In suitable patients (fit, no distant metastases, tumour appears completely resectable and preferably with confirmed viable tumour), this treatment option should be discussed in an experienced multidisciplinary lung cancer team.

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Section: Discussionmentioning

confidence: 99%

Salvage surgery for recurrent or persistent tumour after radical (chemo)radiotherapy for locally advanced non-small cell lung cancer: a systematic review

Dickhoff

Otten

Heymans³

et al. 2018

Ther Adv Med Oncol

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“…The authors demonstrated a significantly shorter disease free survival (DFS) in patients with preoperative detectable CTCs and suggested that ISET and CS should be considered as complementary methods. Recently, Chinniah et al reported the results of a CTC monitoring conducted in 48 patients with locally advanced NSCLC treated with chemoradiotherapy (29). At a median follow-up of 10.9 months, 22 patients (46%) experienced a disease recurrence; moreover, 15 out of the 20 evaluable patients showed elevated CTC counts after treatment and two-thirds of them demonstrated a rise in CTCs counts an average of 6 months before radiographic evidence of recurrence.…”

Section: Prognostic Significance Of Ctcs In Nsclcmentioning

confidence: 99%

Molecular characterization and prognostic significance of circulating tumor cells in patients with non-small cell lung cancer

et al. 2017

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Circulating tumor cells (CTCs) are rare epithelial cells that can be found in the peripheral blood of cancer patients. A growing body of evidence indicates that CTCs may play a role in non-small cell lung cancer (NSCLC) for diagnosis, therapy monitoring and prognostic purposes. CTCs evaluation could be particularly relevant in this clinical setting, considering that physicians often have difficulty in obtaining an adequate tumor tissue and that patients are not always suitable to receive a re-biopsy. In the current review, we will focus on the molecular characterization and prognostic significance of CTCs in NSCLC patients.

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“…Furthermore, a higher CTC count is correlated with a poorer patient prognosis [ 1 , 2 , 5 ]. Most recently, results from a prospective clinical trial show that CTC’s appear in the bloodstream an average of 6 months prior to detection on a PET/CTC scan [ 9 ]. The vast majority of primary breast cancers are carcinomas, where sarcomas account for less than 1% [ 10 ] and lymphomas less than .5% [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Extracting microtentacle dynamics of tumor cells in a non-adherent environment

et al. 2017

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During metastasis, tumor cells dynamically change their cytoskeleton to traverse through a variety of non-adherent microenvironments, including the vasculature or lymphatics. Due to the challenges of imaging drift in non-adhered tumor cells, the dynamic cytoskeletal phenotypes are poorly understood. We present a new approach to analyze the dynamic cytoskeletal phenotypes of non-adhered cells that support microtentacles (McTNs), which are cell surface projections implicated in metastatic reattachment. Combining a recently-developed cell tethering method with a novel image analysis framework allowed McTN attribute extraction. Full cell outlines, number of McTNs, and distance of McTN tips from the cell body boundary were calculated by integrating a rotating anisotropic filtering method for identifying thin features with retinal segmentation and active contour algorithms. Tethered cells behave like free-floating cells; however tethering reduces cell drift and improves the accuracy of McTN measurements. Tethering cells does not significantly alter McTN number, but rather allows better visualization of existing McTNs. In drug treatment experiments, stabilizing tubulin with paclitaxel significantly increases McTN length, while destabilizing tubulin with colchicine significantly decreases McTN length. Finally, we quantify McTN dynamics by computing the time delay autocorrelations of 2 composite phenotype metrics (cumulative McTN tip distance, cell perimeter:cell body ratio). Our automated analysis demonstrates that treatment with paclitaxel increases total McTN amount and colchicine reduces total McTN amount, while paclitaxel also reduces McTN dynamics. This analysis method enables rapid quantitative measurement of tumor cell drug responses within non-adherent microenvironments, using the small numbers of tumor cells that would be available from patient samples.

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Prospective Trial of Circulating Tumor Cells as a Biomarker for Early Detection of Recurrence in Patients with Locally Advanced Non–Small Cell Lung Cancer Treated with Chemoradiation Therapy

Cited by 5 publications

References 0 publications

Salvage surgery for recurrent or persistent tumour after radical (chemo)radiotherapy for locally advanced non-small cell lung cancer: a systematic review

Salvage surgery for recurrent or persistent tumour after radical (chemo)radiotherapy for locally advanced non-small cell lung cancer: a systematic review

Molecular characterization and prognostic significance of circulating tumor cells in patients with non-small cell lung cancer

Extracting microtentacle dynamics of tumor cells in a non-adherent environment

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