Early Detection of Disease Progression in Metastatic Cancers: Could CTCs Improve RECIST Criteria?

Early Detection of Disease Progression in Metastatic Cancers: Could CTCs Improve RECIST Criteria?

Early detection of disease progression is a crucial issue in the management of cancer patients, especially in metastatic settings. Currently, treatment selection mostly relies on criteria based on radiologic evaluations (RECIST). The aim of the present retrospective study is to evaluate the potential inclusion of circulating tumor cells (CTCs) in hybrid criteria. CTC counts from a total of 160 patients with different metastatic tumors were analyzed for this purpose. In our cohort, 73 patients were affected by breast cancer, 69 by colorectal cancer and 18 by prostate cancer. PFS and OS were evaluated according to the corresponding prediction of disease progression by CTCs and RECIST criteria. In breast cancer, CTC-I has an important impact on the progression-free survival (PFS) and overall survival (OS) values. When CTC-I predicted earlier than RECIST-I, the disease progression, the PFS and OS were shorter with respect to the opposite case. In particular, PFS was 11 (5–16) vs. 34 (23–45)—with p < 0.001—and OS was 80 (22–138) vs. 116 (43–189), p = 0.33. The results suggest a promising role of CTCs as complementary information which could significantly improve the clinical outcomes, and they encourage consideration of future trials to evaluate new hybrid criteria, particularly for patients with breast cancer.

This retrospective study evaluated the potential inclusion of circulating tumour cells (CTCs) in hybrid criteria. 160 patients with different metastatic tumours were analysed, 73 breast, 69 CRC, and 18 with prostate cancer. PFS and OS were evaluated by CTCs (CellSearch(r)) and radiological RECIST v 1.1 criteria. Breast cancer shows that CTC-index had an impact on OS. The results suggest a promising role of CTCs as complementary information in breast cancer.

This paper is well thought out in the use of logical approaches in CTCs in defining progression vs non progression. It does suggest the need for the development of a consensus on the subject of liquid biopsy to include all methods of enumerating and partitioning CTCs and including other modalities such as ctDNA.

READ THE ARTICLE – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10887063/

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