title: Prognostic and predictive value of circulating tumor cell analysis in colorectal cancer patients.
abstract: OBJECTIVE
  The aim of this study was to assess the prognostic and predictive values of circulating tumor cell (CTC) analysis in colorectal cancer patients.
  
  
  METHODS
  Presence of CTCs was evaluated in 60 colorectal cancer patients before systemic therapy--from which 33 patients were also evaluable for CTC analysis during the first 3 months of treatment--through immunomagnetic enrichment, using the antibodies BM7 and VU1D9 (targeting mucin 1 and EpCAM, respectively), followed by real-time RT-PCR analysis of the tumor-associated genes KRT19, MUC1, EPCAM, CEACAM5 and BIRC5.
  
  
  RESULTS
  Patients were stratified into groups according to CTC detection (CTC negative, when all marker genes were negative; and CTC positive when at least one of the marker genes was positive). Patients with CTC positivity at baseline had a significant shorter median progression-free survival (median PFS 181.0 days; 95% CI 146.9-215.1) compared with patients with no CTCs (median PFS 329.0 days; 95% CI 299.6-358.4; Log-rank P < .0001). Moreover, a statistically significant correlation was also founded between CTC detection during treatment and radiographic findings at the 6 month staging. This correlation applied to CTC results before therapy (odds ratio (OR), 6.22), 1 to 4 weeks after beginning of treatment (OR, 5.50), 5 to 8 weeks after beginning of treatment (OR, 7.94) 9 to 12 weeks after beginning of treatment (OR, 14.00) and overall CTC fluctuation during the course of treatment (OR, 20.57).
  
  
  CONCLUSIONS
  The present study provides evidence of a strong correlation between CTC detection and radiographic disease progression in patients receiving chemotherapy for colorectal cancer. Our results suggest that in addition to the current prognostic factors, CTC analysis represent a potential complementary tool for prediction of colorectal cancer patients' outcome. Moreover, the present test allows for molecular characterization of CTCs, which may be of relevance to the creation of personalized therapies.
authors.affiliation: Department of Molecular Biology, Zentrum für Diagnostik am Klinikum Chemnitz, Flemmingstrasse 2, 09116 Chemnitz, Germany. Andreia.de.Albuquerque@gmail.com
authors.forename: Andreia
authors.initials: A
authors.lastname: de Albuquerque
authors.forename: Ilja
authors.initials: I
authors.lastname: Kubisch
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stölzel
authors.forename: Dominikus
authors.initials: D
authors.lastname: Ernst
authors.forename: Joachim
authors.initials: J
authors.lastname: Boese-Landgraf
authors.forename: Georg
authors.initials: G
authors.lastname: Breier
authors.forename: Gudrun
authors.initials: G
authors.lastname: Stamminger
authors.forename: Nikos
authors.initials: N
authors.lastname: Fersis
authors.forename: Sepp
authors.initials: S
authors.lastname: Kaul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D011859:Radiography; D060888:Real-Time Polymerase Chain Reaction
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers