Research Papers:
Concordance between circulating tumor cells and clinical status during followup in anaplastic lymphoma kinase ALK nonsmallcell lung cancer patients
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Mariano Provencio1, David Pérez-Callejo1, María Torrente1, Paloma Martin3, Virginia Calvo1, Lourdes Gutiérrez1, Fernando Franco1, Maria José Coronado4, Juan Luis Cruz-Bermúdez5,6, Asunción Martín Ruiz-Valdepeñas1, Alberto Cruz-Bermúdez1, Margarita Sánchez-Beato1, Atocha Romero1 and Aránzazu García-Grande2
1Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Biomedical Sciences Research Institute Puerta de Hierro-Majadahonda (IDIPHIM), Madrid, Spain
2Flow Cytometry Core Facility, Hospital Universitario Puerta de Hierro-Majadahonda, Biomedical Sciences Research Institute Puerta de Hierro-Majadahonda (IDIPHIM), Madrid, Spain
3Pathology Department, Molecular Section, Hospital Universitario Puerta de Hierro-Majadahonda, Biomedical Sciences Research Institute Puerta de Hierro-Majadahonda (IDIPHIM), Madrid, Spain
4Confocal Microscopy Core Facility, Hospital Universitario Puerta de Hierro-Majadahonda, Biomedical Sciences Research Institute Puerta de Hierro-Majadahonda (IDIPHIM), Madrid, Spain
5Information Technologies Department, Hospital Universitario Puerta de Hierro-Majadahonda (IDIPHIM), Madrid, Spain
6Universidad Politécnica de Madrid, Madrid, Spain
Correspondence to:
Mariano Provencio, email: [email protected]
Keywords: liquid biopsy, non-small-cell lung cancer, circulating tumor cells, ALK-rearrangement, ALK inhibitors
Received: February 21, 2017 Accepted: June 29, 2017 Published: July 31, 2017
ABSTRACT
Background: The identification of anaplastic lymphoma kinase (ALK) rearrangements is found in approximately 5% of non-small-cell lung cancers (NSCLCs). However, the development of liquid biopsies as a diagnostic tool is less developed in these cases. This study investigates the use of CTCs during treatment, together with an extended follow-up to correlate with clinical evolution.
Patients and Methods: A total of 13 patients out of a cohort of 212 patients with lung adenocarcinoma, presented ALK rearrangements (6%) confirmed by tumor biopsy. A total of 60 serial blood samples were collected from these patients who were prospectively enrolled in the study.
Results: All patients had a positive CTC count at baseline (mean = 3). The median follow-up was 9 months (range 1-17 months). Three patients underwent surgery and their CTC counts decreased after the procedure but still remained detectable. After radiotherapy, 3 cases showed an average decrease of 5 CTCs. A total of 6 patients were treated with ALK inhibitors and a partial response was observed in 3 of them, who also presented decreased CTC counts. The other 3 patients presented primary resistance, and their CTC counts were higher than those obtained prior to progression.
Conclusion: We believe that the use of CTCs for dynamic monitoring of NSCLC with ALK rearrangement and to detect disease persistence or recurrence may be a reliable technique. CTC counts may also have potential use to monitor the efficacy of ALK inhibitors, facilitating detection of resistance to treatment.