Prognostic impact and potential predictive role of baseline circulating tumor cells in locally advanced head and neck squamous cell carcinoma
| Autor: | Alexcia Camila Braun, Emne Ali Abdallah, Ludmilla Thomé Domingos Chinen, Vinicius Fernando Calsavara, Victor Hugo Fonseca de Jesus, Ulisses Ribaldo Nicolau, Vanessa da Silva Alves, Thiago Bueno Oliveira, Luiz Paulo Kowaslki |
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| Rok vydání: | 2021 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty business.industry Squamous Cell Carcinoma of Head and Neck Head and neck cancer Induction chemotherapy medicine.disease Neoplastic Cells Circulating Prognosis Head and neck squamous-cell carcinoma Circulating tumor cell Head and Neck Neoplasms Internal medicine medicine Biomarkers Tumor Humans Progression-free survival Prospective Studies Oral Surgery Stage (cooking) Liquid biopsy Prospective cohort study business |
| Zdroj: | Oral oncology. 121 |
| ISSN: | 1879-0593 |
| Popis: | Objectives The prognostic impact of circulating tumor cells (CTCs) or circulating tumor microemboli (CTM) in locally advanced head and neck squamous cell carcinoma (LA-HNSCC) is yet to be determined, with conflicting results in previous trials. The role of induction chemotherapy (ICT) in the management of LA-HNSCC is controversial with no predictive biomarkers to guide treatment strategy in this scenario. The aim of this trial is to determine the prognostic impact of CTCs and CTM, their biomarkers expression by immunocytochemistry (ICC), and its potential role as predictors of ICT benefit in LA-HNSCC. Materials and Methods Prospective study, with newly diagnosed stage III/IV non-metastatic LA-HNSCC patients treated with curative intent. Blood samples analyzed for CTCs and CTM before treatment using the ISET method. Results A total of 83 patients were included. CTCs counts were an independent prognostic factor for overall survival (OS; HR: 1.17; 95 %CI: 1.05–1.31; p = 0.005) and progression free survival (PFS; HR:1.14; 95 %CI: 1.03–1.26; p = 0.007). Using the Lausen and Schumacher technique, 2.8 CTCs/mL for OS and 3.8 CTCs/mL for PFS were defined as the best cut-offs. CTM were detected in 27.7% of patients, correlating with worse PFS (HR = 2.70; IC95%: 1.30–5.58; p = 0.007). MRP-7 expression in CTM correlated with worse OS (HR = 3.49; 95 %CI: 1.01–12.04; p = 0.047) and PFS (HR = 3.62; 95 %CI: 1.08–12.13; p = 0.037). CTCs counts were predictive of complete response to treatment (OR = 0.74; 95 %CI: 0.58–0.95; p = 0.022) and high counts (cut-off 3.8/mL) and CTM were potential predictors of ICT benefit. Conclusion CTCs/CTM had significant prognostic impact and potential role as predictors of ICT benefit in LA-HNSCC. |
| Databáze: | OpenAIRE |
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