title: Clinical value of circulating endothelial cell levels in metastatic colorectal cancer patients treated with first-line chemotherapy and bevacizumab.
abstract: BACKGROUND
  We investigated whether circulating endothelial cells (CECs) predict clinical outcome of first-line chemotherapy and bevacizumab in metastatic colorectal cancer (mCRC) patients.
  
  
  METHODS
  In a substudy of the randomized phase II FNCLCC ACCORD 13/0503 trial, CECs (CD45- CD31+ CD146+ 7-amino-actinomycin- cells) were enumerated in 99 patients by four-color flow cytometry at baseline and after one cycle of treatment. We correlated CEC levels with objective response rate (ORR), 6-month progression-free survival (PFS) rate (primary end point of the trial), PFS, and overall survival (OS). Multivariate analyses of potential prognostic factors, including CEC counts and Köhne score, were carried out.
  
  
  RESULTS
  By multivariate analysis, high baseline CEC levels were the only independent prognostic factor for 6-month PFS rate (P < 0.01) and were independently associated with worse PFS (P = 0.02). High CEC levels after one cycle were the only independent prognostic factor for ORR (P = 0.03). High CEC levels at both time points independently predicted worse ORR (P = 0.025), 6-month PFS rate (P = 0.007), and PFS (P = 0.02). Köhne score was the only variable associated with OS.
  
  
  CONCLUSIONS
  CEC levels at baseline and after one treatment cycle may independently predict ORR and PFS in mCRC patients starting first-line bevacizumab and chemotherapy.
authors.affiliation: Gastrointestinal Oncology Unit, Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France.
authors.forename: D
authors.initials: D
authors.lastname: Malka
authors.forename: V
authors.initials: V
authors.lastname: Boige
authors.forename: N
authors.initials: N
authors.lastname: Jacques
authors.forename: N
authors.initials: N
authors.lastname: Vimond
authors.forename: A
authors.initials: A
authors.lastname: Adenis
authors.forename: E
authors.initials: E
authors.lastname: Boucher
authors.forename: J Y
authors.initials: JY
authors.lastname: Pierga
authors.forename: T
authors.initials: T
authors.lastname: Conroy
authors.forename: B
authors.initials: B
authors.lastname: Chauffert
authors.forename: E
authors.initials: E
authors.lastname: François
authors.forename: P
authors.initials: P
authors.lastname: Guichard
authors.forename: M P
authors.initials: MP
authors.lastname: Galais
authors.forename: F
authors.initials: F
authors.lastname: Cvitkovic
authors.forename: M
authors.initials: M
authors.lastname: Ducreux
authors.forename: F
authors.initials: F
authors.lastname: Farace
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D000069287:Capecitabine; D002452:Cell Count; D015179:Colorectal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D042783:Endothelial Cells / Q000473:pathology*; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D000077146:Irinotecan; D053208:Kaplan-Meier Estimate; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D003841:Deoxycytidine; D000068258:Bevacizumab; D000069287:Capecitabine; D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin