A prospective examination of circulating tumor cell profiles in non-small-cell lung cancer molecular subgroups

C. R. Lindsay, V. Faugeroux, S. Michiels, E. Pailler, F. Facchinetti, D. Ou, M. V. Bluthgen, C. Pannet, M. Ngo-Camus, G. Bescher, C. Caramella, F. Billiot, J. Remon, D. Planchard, J. C. Soria, B. Besse, F. Farace

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    Abstract

    Background: We report the first study examining the clinical, numerical and biological properties of circulating tumor cells according to molecular subtypes of non-small-cell lung cancer. Patients and methods: 125 patients with treatment-naïve stage IIIb-IV NSCLC were prospectively recruited for CellSearch analysis. Anti-vimentin antibody was included for examination of CTCs to assess their mesenchymal character. Associations of total CTCs and vimentin-positive (vim +) CTCs with clinical characteristics, tumor genotype, and survival were assessed. Results: 51/125 patients (40.8%) were total CTC+ and 26/125 (20.8%) were vim CTC+ at baseline. Multivariate analysis showed patients with ≥5 total CTCs had significantly reduced OS (HR 0.55, 95% CI 0.33–0.92, P = 0.022) but not PFS (HR 0.68, 95% CI 0.42–1.1, P = 0.118) compared to patients with <5 total CTCs. No OS difference was evident between vim+ CTC and vim-negative CTC patients overall (HR 1.24, 95% CI 0.67–2.28, P = 0.494), but after subdivision according to NSCLC driver mutation, we found an increase of vim+ CTCs in the EGFR-mutated subgroup (N = 21/94 patients; mean 1.24 vs 1.22 vim+ CTCs, P = 0.013), a reduction of total CTCs in the ALK-rearranged subgroup (N = 13/90 patients; mean 1.69 vs 5.82 total CTCs, P = 0.029), and a total absence of vim+ CTCs in KRAS-mutated adenocarcinomas (N = 19/78 patients; mean 0 vs 1.4 vim+ CTCs, P = 0.006). Conclusions: We validate that the baseline presence of ≥5 total CTCs in advanced NSCLC confers a poor prognosis. CTCs from EGFR-mutant NSCLC express epithelial–mesenchymal transition characteristics, not seen in CTCs from patients with KRAS-mutant adenocarcinoma.

    Original languageEnglish
    Pages (from-to)1523-1531
    Number of pages9
    JournalAnnals of Oncology
    Volume28
    Issue number7
    DOIs
    Publication statusPublished - 1 Jul 2017

    Keywords

    • CTC
    • EMT
    • biomarker
    • circulating tumor cell
    • non-small-cell lung cancer
    • vimentin

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