TY - JOUR
T1 - Circulating tumor cells in patients with recurrent or metastatic head and neck carcinoma
T2 - Prognostic and predictive significance
AU - Grisanti, Salvatore
AU - Almici, Camillo
AU - Consoli, Francesca
AU - Buglione, Michela
AU - Verardi, Rosanna
AU - Bolzoni-Villaret, Andrea
AU - Bianchetti, Andrea
AU - Ciccarese, Chiara
AU - Mangoni, Monica
AU - Ferrari, Laura
AU - Biti, Gianpaolo
AU - Marini, Mirella
AU - Ferrari, Vittorio D.
AU - Nicolai, Piero
AU - Magrini, Stefano M.
AU - Berruti, Alfredo
PY - 2014/8/8
Y1 - 2014/8/8
N2 - Introduction: We investigated the frequency of detection and the prognostic and predictive significance of circulating tumor cells (CTCs) in patients with recurrent/metastatic (R/M) head and neck carcinoma (HNC) before starting systemic therapy. Patients and methods: Using the CellSearch technology, CTCs were assessed prospectively in peripheral blood of 53 R/M-HNC patients. We performed spiking experiments to test the diagnostic performance of the CellSearch platform in identifying squamous carcinoma cells. Results: CTCs were identified in 14 (26%) and 22 (41%) patients at baseline and at any time point, respectively. In univariate analysis ≥2 CTCs had a poorer prognostic role than 0-1 CTC. In multivariate analysis, the presence of one CTC or more was associated with a poor prognosis both in terms of progression-free survival (PFS) [Hazard Ratio (HR): 3.068, 95% confidence interval (CI): 1.53-6.13, p 0.002] and overall survival (OS) [HR: 3.0, 95% CI: 1.48-6.0, p 0.002]. A disease control after systemic therapy was obtained in 8% of CTC-positive patients as opposed to 45% in CTC-negative ones (p 0.03). The epidermal growth factor receptor (EGFR) expression was identified in 45% of CTC-positive patients. Discussion: In conclusion, CTCs are detected in one out of three patients with RM-HNC. CTC detection is a strong prognostic parameter and may be predictive of treatment efficacy. The frequency of EGFR expression in CTCs seems to be lower than that expected in the primary tumor.
AB - Introduction: We investigated the frequency of detection and the prognostic and predictive significance of circulating tumor cells (CTCs) in patients with recurrent/metastatic (R/M) head and neck carcinoma (HNC) before starting systemic therapy. Patients and methods: Using the CellSearch technology, CTCs were assessed prospectively in peripheral blood of 53 R/M-HNC patients. We performed spiking experiments to test the diagnostic performance of the CellSearch platform in identifying squamous carcinoma cells. Results: CTCs were identified in 14 (26%) and 22 (41%) patients at baseline and at any time point, respectively. In univariate analysis ≥2 CTCs had a poorer prognostic role than 0-1 CTC. In multivariate analysis, the presence of one CTC or more was associated with a poor prognosis both in terms of progression-free survival (PFS) [Hazard Ratio (HR): 3.068, 95% confidence interval (CI): 1.53-6.13, p 0.002] and overall survival (OS) [HR: 3.0, 95% CI: 1.48-6.0, p 0.002]. A disease control after systemic therapy was obtained in 8% of CTC-positive patients as opposed to 45% in CTC-negative ones (p 0.03). The epidermal growth factor receptor (EGFR) expression was identified in 45% of CTC-positive patients. Discussion: In conclusion, CTCs are detected in one out of three patients with RM-HNC. CTC detection is a strong prognostic parameter and may be predictive of treatment efficacy. The frequency of EGFR expression in CTCs seems to be lower than that expected in the primary tumor.
UR - http://www.scopus.com/inward/record.url?scp=84905660835&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0103918
DO - 10.1371/journal.pone.0103918
M3 - Journal articles
C2 - 25105871
AN - SCOPUS:84905660835
SN - 1553-7390
VL - 9
JO - PLoS ONE
JF - PLoS ONE
IS - 8
M1 - e103918
ER -
