Dynamic Monitoring of CTCs Could Predict Prognosis in SCLC Patients

Researchers found that dynamic monitoring of circulating tumor cells (CTCs) levels may be an effective, non-invasive way to predict disease progression and prognosis in patients with small-cell lung cancer (Cancer Control. 10732748211050581.). 

“Numerous studies have elucidated that circulating tumor cells have significant prognostic value in various solid tumors. However, the prognostic value of CTCs in small cell lung cancer remains controversial,” explained Ai-Min Jiang, Department of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, China, and colleagues.

With this in mind, researchers investigated the prognostic significance of different time points of CTCs in SCLC.

Eligible studies were pulled from databases across PubMed, EMBASE, Web of Science, and Cochrane Library. Additionally, to see if there was a link between CTCs level and overall survival (OS) and progression-free survival (PFS), pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Also conducted were: subgroup analyses, sensitivity analysis, Begg’s and Egger’s tests.

A total of 1103 participants across 16 cohort studies were included in this meta-analysis. Researchers found that higher pretreatment CTCs level significantly correspond with a worse OS in SCLC (HR, 2.95; 95%CI, 1.56-5.58; P=.001), regardless of CellSearch or other methods used to detect CTCs (HR, 2.37; 95%CI, 1.13-4.99; P=.023). 

Additionally, higher pretreatment CTCs status as detected by CellSearch were linked to a shorter PFS (HR, 3.75; 95%CI, 2.52-5.57; P<.001). Although higher post-therapy CTCS, as detected by both CellSearch (HR, 2.99; 95%CI, 1.51-5.93; P=.002) and other methods (HR, 4.79; 95%CI, 2.03-11.32; P<.001), were associated with decreased OS, it was not associated with a worse PFS  (HR, 1.80; 95%CI, .83-3.90; P=.135).

Sensitivity analysis revealed that polled data were stable after eliminating studies one by one, but a significant publication bias was observed between pretreatment CTCs level detected by CellSearch and OS of SCLC.

“Dynamic monitoring of CTCs level could be a non-invasive and effective tool to predict the disease progression and prognosis in patients with SCLC,” concluded Dr Jiang et al.—Alexandra Graziano