Detection of circulating tumor cells in patients with urothelial cancer.
BACKGROUND
Approximately 50% of patients with metastatic urothelial cancer (UC) respond to chemotherapy and several months of therapy is required to assess for radiographic response. Blood-based biomarkers may identify patients in whom a specific therapy provides clinical benefit, and this study sought to characterize circulating tumor cells (CTCs) in patients with metastatic UC.


METHODS
Peripheral blood from patients with metastatic UC was evaluated for CTCs using the CellSearch system. We assessed for associations between CTC counts and the number and sites of metastatic disease.


RESULTS
CTC evaluations were carried out in 33 patients with metastatic UC. Fourteen of 33 patients (44%; 95% confidence interval 27% to 59%) had a positive assay (range 0-87 cells/7.5 ml of blood) with 10 patients (31%) having five or more CTCs. A significantly higher number of CTCs was seen in patients with two or more sites of metastases compared with those with less than one or one site of metastases (3.5 versus 0, P = 0.04).


CONCLUSIONS
CTCs, detected by antibody capture technology, are present in 44% of patients with metastatic UC. Higher numbers of CTCs are seen in patients with a greater number of metastatic sites. One-third of patients have five or more CTCs providing a potential early marker to monitor response to chemotherapy.
Genitourinary Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center and Joan and Sanford Weill Medical College of Cornell University, New York, NY 10021, USA.
D J
DJ
Gallagher
M I
MI
Milowsky
N
N
Ishill
A
A
Trout
M G
MG
Boyle
J
J
Riches
M
M
Fleisher
D F
DF
Bajorin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D015331:Cohort Studies; D005260:Female; D006801:Humans; D018189:Immunomagnetic Separation; D007682:Kidney Pelvis / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology*; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D010865:Pilot Projects; D011446:Prospective Studies; D014513:Ureter / Q000473:pathology; D001743:Urinary Bladder / Q000473:pathology; D014571:Urologic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D019459:Urothelium / Q000473:pathology*