Improved prognostic stratification using circulating tumor cell clusters in patients with metastatic castration-resistant prostate cancer

Chun Wang, Zhenchao Zhang, Weelic Chong, Rui Luo, Ronald E. Myers, Jian Gu, Jianqing Lin, Qiang Wei, Bingshan Li, Timothy R. Rebbeck, Grace Lu-Yao, William K. Kelly, Hushan Yang

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Liquid biopsy-based biomarkers have advantages in monitoring the dynamics of metastatic castration-resistant prostate cancer (mCRPC), a bone-predominant metastatic disease. Previous studies have demonstrated associations between circulating tumor cells (CTCs) and clinical outcomes of mCRPC patients, but little is known about the prognostic value of CTC-clusters. In 227 longitudinally collected blood samples from 64 mCRPC patients, CTCs and CTC-clusters were enumerated using the CellSearch platform. The associations of CTC and CTC-cluster counts with progression-free survival (PFS) and overall survival (OS), individually and jointly, were evaluated by Cox models. CTCs and CTC-clusters were detected in 24 (37.5%) and 8 (12.5%) of 64 baseline samples, and in 119 (52.4%) and 27 (11.9%) of 227 longitudinal samples, respectively. CTC counts were associated with both PFS and OS, but CTC-clusters were only independently associated with an increased risk of death. Among patients with unfavorable CTCs (≥5), the presence of CTC-clusters signified a worse survival (log-rank p = 0.0185). mCRPC patients with both unfavorable CTCs and CTC-clusters had the highest risk for death (adjusted hazard ratio 19.84, p = 0.0072), as compared to those with <5 CTCs. Analyses using longitudinal data yielded similar results. In conclusion, CTC-clusters provided additional prognostic information for further stratifying death risk among patients with unfavorable CTCs.

Original languageEnglish (US)
Article number268
Pages (from-to)1-13
Number of pages13
JournalCancers
Volume13
Issue number2
DOIs
StatePublished - Jan 2 2021

Keywords

  • Circulating tumor cell
  • Circulating tumor cell cluster
  • Metastatic castration-resistant prostate cancer
  • Overall survival
  • Progression-free survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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