Circulating Tumor Cell Enumeration for Serial Monitoring of Treatment Outcomes for Locally Advanced Esophageal Squamous Cell Carcinoma

• Published in: Cancers Vol. 15; no. 3; p. 832
• Main Authors: Ko, Josephine Mun Yee, Lam, Ka On, Kwong, Dora Lai Wan, Wong, Ian Yu-Hong, Chan, Fion Siu-Yin, Wong, Claudia Lai-Yin, Chan, Kwan Kit, Law, Tsz Ting, Chiu, Keith Wan Hang, Lam, Candy Chi Shan, Wong, Jean Chrysei, Fong, Henry Chun Hung, Choy, Faith Sin Fai, Lo, Andy, Law, Simon, Lung, Maria Li
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 29.01.2023; MDPI
• Subjects: Antibodies; Antigens; Biomarkers; Biopsy; Blood; Cancer cells; Cancer therapies; Care and treatment; Enumeration; Esophageal cancer; Esophagus; Experiments; Health aspects; Mesenchyme; Metabolic disorders; Metastasis; Minimal residual disease; Patient outcomes; Patients; Peripheral blood; Physiological aspects; Prognosis; Reproducibility; Squamous cell carcinoma; Surgery; Tomography; Tumor cells; Tumors; Vimentin; China; United States > US; Europe; circulating tumor cells (CTC); CTC clusters; longitudinal real-time monitoring; early prediction; non-invasive biomarker; azygos vein blood; EMT; advanced ESCC; prognosis; liquid biopsy
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers15030832

We aim to reveal the clinical significance and potential usefulness of dynamic monitoring of CTCs to track therapeutic responses and improve survival for advanced ESCC patients. Peripheral blood (PB) ( = 389) and azygos vein blood (AVB) ( = 13) samplings were recruited prospectively from 88 ESCC patients undergoing curative surgery from 2017 to 2022. Longitudinal CTC enumeration was performed with epithelial (EpCAM/pan-cytokeratins/MUC1) and mesenchymal (vimentin) markers at 12 serial timepoints at any of the pre-treatment, all of the post-treatments/pre-surgery, post-surgery follow-ups for 3-year, and relapse. Longitudinal real-time CTC analysis in PB and AVB suggests more CTCs are released early at pre-surgery and 3-month post-surgery into the circulation from the CTRT group compared to the up-front surgery group. High CTC levels at pre-treatments, 1-/3-month post-surgery, unfavorable changes of CTC levels between all post-treatment/pre-surgery and 1-month or 3-month post-surgery (Hazard Ratio (HR) = 6.662, < 0.001), were independent prognosticators for curative treatment. The unfavorable pre-surgery CTC status was independent prognostic and predictive for neoadjuvant treatment efficacy (HR = 3.652, = 0.035). The aggressive CTC clusters were more frequently observed in AVB compared to PB. Its role as an independent prognosticator with relapse was first reported in ESCC (HR = 2.539, = 0.068). CTC clusters and longitudinal CTC monitoring provide useful prognostic information and potential predictive biomarkers to help guide clinicians in improving disease management.