title: Circulating tumor cells in locally advanced pancreatic adenocarcinoma: the ancillary CirCe 07 study to the LAP 07 trial.
abstract: BACKGROUND
  Pancreatic carcinoma is one of the leading causes of cancer-related mortality. At the time of diagnosis, 30% of patients present with a locally advanced pancreatic carcinoma (LAPC). As circulating tumor cells (CTCs) count may be a surrogate of the cancer metastatic abilities, CTC detection rates and prognostic value were studied in a prospective cohort of LAPC patients.
  
  
  METHODS
  An LAP07 international multicenter randomized study assesses in patients whose LAPC is controlled after 4 months of chemotherapy whether chemoradiotherapy could increase survival versus continuation of chemotherapy. A subgroup of patients included in the LAP07 trial was screened for CTCs (CellSearch®) before the start of the chemotherapy and after 2 months of treatment. Patient characteristics and survival were obtained prospectively and were correlated with CTC detection.
  
  
  RESULTS
  Seventy-nine patients were included. One or more CTCs/7.5 ml were detected in 5% of patients before treatment and in 9% of patients after 2 months of treatment (overall detection rate: 11% of patients). CTC positivity was associated with poor tumor differentiation (P = 0.04), and with shorter overall survival (OS) in multivariable analysis (RR = 2.5, P = 0.01), together with anemia.
  
  
  CONCLUSIONS
  The evaluation of micrometastatic disease using CTC detection appears as a promising prognostic tool in LAPC patients.
authors.affiliation: Department of Medical Oncology, Institut Curie, Paris, France. fcbidard@curie.fr
authors.forename: F C
authors.initials: FC
authors.lastname: Bidard
authors.forename: F
authors.initials: F
authors.lastname: Huguet
authors.forename: C
authors.initials: C
authors.lastname: Louvet
authors.forename: L
authors.initials: L
authors.lastname: Mineur
authors.forename: O
authors.initials: O
authors.lastname: Bouché
authors.forename: B
authors.initials: B
authors.lastname: Chibaudel
authors.forename: P
authors.initials: P
authors.lastname: Artru
authors.forename: F
authors.initials: F
authors.lastname: Desseigne
authors.forename: J B
authors.initials: JB
authors.lastname: Bachet
authors.forename: C
authors.initials: C
authors.lastname: Mathiot
authors.forename: J Y
authors.initials: JY
authors.lastname: Pierga
authors.forename: P
authors.initials: P
authors.lastname: Hammel
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor; D059248:Chemoradiotherapy; D015331:Cohort Studies; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis*; D009360:Neoplastic Cells, Circulating; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D011446:Prospective Studies; D013534:Survival; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D014408:Biomarkers, Tumor; D003841:Deoxycytidine; D000093542:Gemcitabine
keywords: CirCe 07; LAP 07; chemoradiotherapy; circulating tumor cells; gemcitabine; locally advanced pancreatic cancer