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. 2023 Apr 16;12(8):1172.
doi: 10.3390/cells12081172.

Prognostic Role of Circulating Tumor Cell Trajectories in Metastatic Colorectal Cancer

Valentina Magri  1 , Luca Marino  2 , Chiara Nicolazzo  3 , Angela Gradilone  3 , Gianluigi De Renzi  3 , Michela De Meo  3 , Orietta Gandini  3 , Arianna Sabatini  1 , Daniele Santini  1 , Enrico Cortesi  1 , Paola Gazzaniga  3
Affiliations

Prognostic Role of Circulating Tumor Cell Trajectories in Metastatic Colorectal Cancer

Valentina Magri et al. Cells. .

Abstract

Background: A large amount of evidence from clinical studies has demonstrated that circulating tumor cells are strong predictors of outcomes in many cancers. However, the clinical significance of CTC enumeration in metastatic colorectal cancer is still questioned. The aim of this study was to evaluate the clinical value of CTC dynamics in mCRC patients receiving first-line treatments.

Materials and methods: Serial CTC data from 218 patients were used to identify CTC trajectory patterns during the course of treatment. CTCs were evaluated at baseline, at a first-time point check and at the radiological progression of the disease. CTC dynamics were correlated with clinical endpoints.

Results: Using a cut-off of ≥1 CTC/7.5 mL, four prognostic trajectories were outlined. The best prognosis was obtained for patients with no evidence of CTCs at any timepoints, with a significant difference compared to all other groups. Lower PFS and OS were recognized in group 4 (CTCs always positive) at 7 and 16 months, respectively.

Conclusions: We confirmed the clinical value of CTC positivity, even with only one cell detected. CTC trajectories are better prognostic indicators than CTC enumeration at baseline. The reported prognostic groups might help to improve risk stratification, providing potential biomarkers to monitor first-line treatments.

Keywords: CellSearch®; circulating tumor cell trajectories; circulating tumor cells; liquid biopsy; metastatic colorectal cancer; precision medicine; prognostic and predictive biomarkers.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Maier survival curves (probability) for PFS (top) and OS (bottom). Comparison between the 4 trajectory groups. Group 1 (119 patients) CTC-ND (baseline)/CTC-ND (progression disease). Group 2 (48 patients): CTC-ND (baseline)/CTC+ (progression disease). Group 3 (16 patients): CTC+ (baseline)/CTC-ND (progression disease). Group 4 (35 patients): CTC+ (baseline)/CTC+ (progression disease).
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This study was funded by Sapienza University of Rome (protocol number C26A09LB5J). The funding sources had no role in the study design or in the collection, analysis or interpretation of data.
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