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Longitudinal Assessment of Circulating Tumor Cells and Outcome in Small Cell Lung Cancer : A Sub-Study of RASTEN—A Randomized Trial with Low Molecular Weight Heparin

Bendahl, Pär Ola LU ; Belting, Mattias LU and Gezelius, Emelie LU (2023) In Cancers 15(12).
Abstract

Circulating tumor cells (CTCs) may provide a liquid biopsy approach to disease monitoring in small cell lung cancer (SCLC), a particularly aggressive tumor subtype. Yet, the prognostic role of CTCs during and after treatment in relation to baseline remains ill-defined. Here, we assessed the value of longitudinal CTC analysis and the potential of low-molecular-weight heparin (LMWH) to reduce CTC abundance in SCLC patients from a randomized trial (RASTEN). Blood samples were collected at baseline, before chemotherapy Cycle 3, and at 2-month follow-up from 42 patients in total, and CTCs were quantified using the FDA-approved CellSearch system. We found a gradual decline in CTC count during and after treatment, independently of the addition... (More)

Circulating tumor cells (CTCs) may provide a liquid biopsy approach to disease monitoring in small cell lung cancer (SCLC), a particularly aggressive tumor subtype. Yet, the prognostic role of CTCs during and after treatment in relation to baseline remains ill-defined. Here, we assessed the value of longitudinal CTC analysis and the potential of low-molecular-weight heparin (LMWH) to reduce CTC abundance in SCLC patients from a randomized trial (RASTEN). Blood samples were collected at baseline, before chemotherapy Cycle 3, and at 2-month follow-up from 42 patients in total, and CTCs were quantified using the FDA-approved CellSearch system. We found a gradual decline in CTC count during and after treatment, independently of the addition of LMWH to standard therapy. Detectable CTCs at baseline correlated significantly to reduced survival compared to undetectable CTCs (unadjusted hazard ratio (HR) of 2.75 (95% CI 1.05–7.20; p = 0.040)). Furthermore, a persistent CTC count at 2-month follow-up was associated with a HR of 4.22 (95% CI 1.20–14.91; p = 0.025). Our findings indicate that persistently detectable CTCs during and after completion of therapy offer further prognostic information in addition to baseline CTC, suggesting a role for CTC in the individualized management of SCLC.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
circulating tumor cells, liquid biopsy, prognostic biomarker, small cell lung cancer
in
Cancers
volume
15
issue
12
article number
3176
publisher
MDPI AG
external identifiers
  • scopus:85163928487
  • pmid:37370786
ISSN
2072-6694
DOI
10.3390/cancers15123176
language
English
LU publication?
yes
id
8809f973-b014-4c29-a4ef-3398ea85af77
date added to LUP
2023-09-18 13:59:36
date last changed
2024-12-29 03:11:01
@article{8809f973-b014-4c29-a4ef-3398ea85af77,
  abstract     = {{<p>Circulating tumor cells (CTCs) may provide a liquid biopsy approach to disease monitoring in small cell lung cancer (SCLC), a particularly aggressive tumor subtype. Yet, the prognostic role of CTCs during and after treatment in relation to baseline remains ill-defined. Here, we assessed the value of longitudinal CTC analysis and the potential of low-molecular-weight heparin (LMWH) to reduce CTC abundance in SCLC patients from a randomized trial (RASTEN). Blood samples were collected at baseline, before chemotherapy Cycle 3, and at 2-month follow-up from 42 patients in total, and CTCs were quantified using the FDA-approved CellSearch system. We found a gradual decline in CTC count during and after treatment, independently of the addition of LMWH to standard therapy. Detectable CTCs at baseline correlated significantly to reduced survival compared to undetectable CTCs (unadjusted hazard ratio (HR) of 2.75 (95% CI 1.05–7.20; p = 0.040)). Furthermore, a persistent CTC count at 2-month follow-up was associated with a HR of 4.22 (95% CI 1.20–14.91; p = 0.025). Our findings indicate that persistently detectable CTCs during and after completion of therapy offer further prognostic information in addition to baseline CTC, suggesting a role for CTC in the individualized management of SCLC.</p>}},
  author       = {{Bendahl, Pär Ola and Belting, Mattias and Gezelius, Emelie}},
  issn         = {{2072-6694}},
  keywords     = {{circulating tumor cells; liquid biopsy; prognostic biomarker; small cell lung cancer}},
  language     = {{eng}},
  number       = {{12}},
  publisher    = {{MDPI AG}},
  series       = {{Cancers}},
  title        = {{Longitudinal Assessment of Circulating Tumor Cells and Outcome in Small Cell Lung Cancer : A Sub-Study of RASTEN—A Randomized Trial with Low Molecular Weight Heparin}},
  url          = {{http://dx.doi.org/10.3390/cancers15123176}},
  doi          = {{10.3390/cancers15123176}},
  volume       = {{15}},
  year         = {{2023}},
}