Circulating tumor cells as a surrogate marker for determining clinical outcome to mFOLFOX chemotherapy in patients with stage III colon cancer - PubMed (original) (raw)

Circulating tumor cells as a surrogate marker for determining clinical outcome to mFOLFOX chemotherapy in patients with stage III colon cancer

C-Y Lu et al. Br J Cancer. 2013.

Abstract

Background: This study was aimed to detect post-chemotherapeutic circulating tumour cells (CTCs) in stage III colon cancer patients and identify those who were at high risk of relapse.

Methods: We used human telomerase reverse transcriptase, cytokeratin-19, cytokeratin-20, and carcinoembryonic antigen (CEA) as the biomarkers to detect CTCs in 90 stage III colon cancer patients undergoing curative resection followed by mFOLFOX chemotherapy.

Results: Post-chemotherapeutic relapse occurred in 30 (33.3%) patients. By univariate analysis and multivariate proportional hazards regression analysis, perineural invasion (hazard ratio (HR): 2.752; 95% confidence interval (CI): 1.026-7.381), high post-chemotherapeutic serum CEA levels (HR: 2.895; 95% CI: 1.143-7.333) and persistent presence of post-chemotherapeutic CTCs (HR: 6.273; 95% CI: 2.442-16.117) were independent predictors of post-chemotherapeutic relapse. In addition, the persistent presence of post-chemotherapeutic CTCs strongly correlated with reduced disease-free survival and overall survival. Accuracy of detecting relapse in post-chemotherapeutic stage III colon cancer patients by analysing the persistent presence of post-chemotherapeutic CTCs was higher than that by post-chemotherapeutic CEA levels (odds ratio: 50.091 vs 5.211).

Conclusion: The persistent presence of post-chemotherapeutic CTCs is a potential powerful surrogate marker for determining clinical outcome in stage III colon cancer patients receiving adjuvant mFOLFOX chemotherapy.

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Figures

Figure 1

(A) Cumulative disease-free survival (DFS) of 90 stage III colon cancer patients undergoing mFOLFOX chemotherapy according to the post-chemotherapeutic presence of circulating tumour cells (CTCs). Colon cancer patients with positive CTCs in peripheral blood showed a significantly reduced DFS than those without CTCs in the peripheral blood (P<0.001); (B) Cumulative OS of 90 stage III colon cancer patients undergoing mFOLFOX chemotherapy according to the post-chemotherapeutic presence of CTCs. Colon cancer patients with persistent post-chemotherapeutic CTCs in peripheral blood showed a significantly reduced OS than those without CTCs in the peripheral blood (P<0.001).

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Circulating tumor cells as a surrogate marker for determining clinical outcome to mFOLFOX chemotherapy in patients with stage III colon cancer - PubMed (original) (raw)