Introduction & Objectives: The increasing need to improve the capability of monitoring cancer diseases and to tailor therapies to patients has incited researchers to define new markers able to modify therapeutic decision. Circulating tumour cells (CTCs) seems to have predictive and prognostic impact in several solid tumours and also in CRPC. We aimed to explore the prevalence and role of CTCs levels in this population. Material & Methods: Since September 2006 we collected blood samples from 35 pts with CRPC treated with chemotherapy. Whole blood samples of each patient are collected into the Cell Save Preservative Tube (Veridex LLC, Raritan, NJ) and analysed for CTCs. Mononuclear cells fraction are isolated using epithelial cell antibody-coated magnetic nanoparticles, fluorescently labelled. Then CTCs are identified with automated fluorescent microscopy. Timing of collection was baseline, after three, six, nine weeks of treatment and during every instrumental evaluation until disease progression. Results: To date 35 of planned 54 pts have been enrolled. Median age: 72 (55-84). Median basal PSA was 131 (12.5-2899). Preliminary results showed 71% prevalence of intact CTCs >5/7.5 mL and 50% prevalence of intact CTCs >20/7.5mL. CTCs number ranged from 0 to 1959/7.5 mL (mean 143; median 19.5). The median value of basal CTCs correlate with the number of previous CRPC treatments even if the statistical significance is not still reached (p-value 0.099). At the basal determination, CTCs show a positive correlation with PSA levels (p-value=0.003), alkaline phosphatase determination (p-value <0.001) and a negative correlation with Hb (p-value 0.039). A value of CTCs >20 after 6 weeks from the beginning of the therapy is correlated with a significant decrease in progression free survival (p-value 0.025). Conclusions: Our data showed a significant high level of CTCs in the majority of CRPC pts. CTCs seem to confirm their prognostic and predictive value but we need a larger sample population and a longer follow up period in order to confirm the data.
IMMUNOMAGNETIC QUANTIFICATION OF CIRCULATING TUMOUR CELLS (CTCS) AS NEW PROGNOSTIC AND PREDICTIVE FACTOR IN CASTRATION RESISTANT PROSTATE CANCER (CRPC): PRELIMINARY RESULTS / Cossu Rocca, M.; Verri, E.; Sandri, M. T.; Marenghi, C.; Botteri, E.; Adamoli, L.; Curigliano, G.; De Cobelli, O.; Rocco, Bernardo Maria Cesare; Zorzino, L.; Cassatella, M. C.; Nole, F.. - In: EUROPEAN UROLOGY. SUPPLEMENTS. - ISSN 1569-9056. - 8:4(2009), pp. 296-296.
IMMUNOMAGNETIC QUANTIFICATION OF CIRCULATING TUMOUR CELLS (CTCS) AS NEW PROGNOSTIC AND PREDICTIVE FACTOR IN CASTRATION RESISTANT PROSTATE CANCER (CRPC): PRELIMINARY RESULTS
ROCCO, Bernardo Maria Cesare;
2009
Abstract
Introduction & Objectives: The increasing need to improve the capability of monitoring cancer diseases and to tailor therapies to patients has incited researchers to define new markers able to modify therapeutic decision. Circulating tumour cells (CTCs) seems to have predictive and prognostic impact in several solid tumours and also in CRPC. We aimed to explore the prevalence and role of CTCs levels in this population. Material & Methods: Since September 2006 we collected blood samples from 35 pts with CRPC treated with chemotherapy. Whole blood samples of each patient are collected into the Cell Save Preservative Tube (Veridex LLC, Raritan, NJ) and analysed for CTCs. Mononuclear cells fraction are isolated using epithelial cell antibody-coated magnetic nanoparticles, fluorescently labelled. Then CTCs are identified with automated fluorescent microscopy. Timing of collection was baseline, after three, six, nine weeks of treatment and during every instrumental evaluation until disease progression. Results: To date 35 of planned 54 pts have been enrolled. Median age: 72 (55-84). Median basal PSA was 131 (12.5-2899). Preliminary results showed 71% prevalence of intact CTCs >5/7.5 mL and 50% prevalence of intact CTCs >20/7.5mL. CTCs number ranged from 0 to 1959/7.5 mL (mean 143; median 19.5). The median value of basal CTCs correlate with the number of previous CRPC treatments even if the statistical significance is not still reached (p-value 0.099). At the basal determination, CTCs show a positive correlation with PSA levels (p-value=0.003), alkaline phosphatase determination (p-value <0.001) and a negative correlation with Hb (p-value 0.039). A value of CTCs >20 after 6 weeks from the beginning of the therapy is correlated with a significant decrease in progression free survival (p-value 0.025). Conclusions: Our data showed a significant high level of CTCs in the majority of CRPC pts. CTCs seem to confirm their prognostic and predictive value but we need a larger sample population and a longer follow up period in order to confirm the data.
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