Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Prognostic importance of circulating tumor cells in non-small cell lung cancer: a prospective study

Hong-Xia Bi¹, Han-Bing Shi¹, Xing-Yuan Sun², Jiang Su³, Zong-Fu Mao⁴

¹Department of Respiratory; ²Department of Neurology, the Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000; ³Department of Office, Qiqihar Medical University, Qiqihar 161006; ⁴Social Medicine and Health Management, School of Public Health, Wuhan University, Wuhan, Hubei 430071, China.

For correspondence:- Zong-Fu Mao Email: maozongfu7890@gmail.com Tel:+862787331398

Received: 4 December 2014 Accepted: 20 July 2015 Published: 29 September 2015

Citation: Bi H, Shi H, Sun X, Su J, Mao Z. Prognostic importance of circulating tumor cells in non-small cell lung cancer: a prospective study. Trop J Pharm Res 2015; 14(9):1723-1731 doi: 10.4314/tjpr.v14i9.26

© 2015 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To investigate the prognostic value of circulating tumor cells (CTCs) and to predict the treatment response in a non-small cell lung cancer (NSCLC).

Methodology: A single-center prospective study involving 93 patients with NSCLC was conducted. Blood samples were analyzed for CTC count before and after chemotherapy. Clinical relevance of CTCs with patient`s characteristics and treatment response were determined.

Results: Higher levels of CTCs were associated with severe stage of NSCLC (p = 0.003), tumor histology (p = 0.014) and metastases (p = 0.013). Significant difference in CTC count was observed in favorable (CTCs < 5) and unfavorable (CTCs ≥ 5) groups. Progression-free survival (PFS) was 5.8 months (range: 5.32 to 6.43) and 2.2 months (range: 1.85 to 3.01) in the favorable and unfavorable groups, respectively (HR: 3.88, 95% CI, p < 0.001). Similarly, overall survival (OS) was 7.3 months (95% CI, 6.51 to 7.92) and 3.9 months (95% CI, 1.99 to 5.13), respectively (HR: 4.8, 95% CI, p < 0.001). Multivariate regression analysis revealed CTCs as strong predictors of OS and PFS. Significant reduction (p < 0.001) in CTC count was also observed after one cycle of chemotherapy.

Conclusion: Patients with low CTC count live longer and remain progression-free for a longer period of time than those with high CTC count. High CTCs can be detected in severe forms of lung cancer and can be used as a valid prognostic marker. However, this assertion requires validation in larger prospective clinical cohorts.

Keywords: Circulating tumor cells, Non-small cell lung cancer, Circulating tumor cell, Prognosis