1313 - Prognostic significance of EGFR, HER-2, CEA on circulating tumour cells (CTCs) in patients with metastatic non-small-cell lung cancer (mNSCLC)

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Biomarkers
Non-Small-Cell Lung Cancer, Metastatic
Presenter Cristian Loretelli
Authors C. Loretelli1, E. Galizia2, M. Scartozzi3, R. Giampieri3, D. Gagliardini4, C. Brugiati4, S. Cascinu5, R. Cellerino4
  • 1AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, 60126 - Ancona/IT
  • 2Oncologia Medica, Ospedale "E. profili", 60044 - Fabriano/IT
  • 3Clinica Di Oncologia Medica, AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, 60126 - Ancona/IT
  • 4Clinica Di Oncologia Medica, Ospedali Riuniti Ancona Università Politecnica delle Marche, 60020 - Ancona/IT
  • 5Dipartimento Di Medicina Clinica E Biotecnologie A, AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, 60126 - Ancona/IT

Abstract

Purpose

We aimed to assess the role of CTCs in providing prognostic information of mNSCLC patients receiving chemotherapy.

Patients and methods

In this single-center prospective study, blood samples for CTCs analysis were obtained from patients with previously untreated mNSCLC. CTCs were measured using an epithelial cell adhesion molecule-based immunomagnetic technique. Immunomagnetic bead enrichment for cells expressing epithelial cell adhesion molecule (EpCAM) was performed, followed by multi-marker quantitative real-time PCR of a panel of marker genes: EGFR, HER-2, CEA.

Results

We analysed 45 patients with mNSCLC: 24 adenocarcinoma, 8 squamous cell carcinoma and 13 poorly differentiated. EGFR, HER-2 and CEA expression were found in CTCs of respectively 12, 5 and 11 patients. Globally, 31 patients (68.9%) progressed during treatment, whereas disease control (i.e. patients with partial/complete response or stable disease) was achieved in 14 patients (31.1%). EGFR expression was detected in 11/31 patients with disease progression (35.5%) and in only 1 out of 14 patients with disease controlled (7.1%) (p 0.07). HER-2 expression was detected in 3/31 patients with disease progression (9.7%) and in 2/14 patients with disease controlled (14.3%) (p 0.64). CEA expression was detected in 10/31 patients with disease progression (32.3%) and in 1/14 patients with disease controlled (7.1%) (p 0.13). Only EGFR expression in CTCs showed a correlation with clinical outcome, expressed by progression free survival (PFS). Patients with and without EGFR expression in CTCs were homogeneous for clinical characteristics. PFS was 2.8 v 2.3 months (p 0.03) respectively for patients without and with EGFR expression.

Conclusion

CTCs are detectable in patients with mNSCLC and could show novel prognostic factor for this disease. Further validation is warranted before routine clinical application.

Disclosure

All authors have declared no conflicts of interest.