title: A pilot study assessing the incidence and clinical significance of circulating tumor cells in esophagogastric cancers.
abstract: BACKGROUND
  Circulating tumor cells (CTCs) have been found to be of clinical utility in predicting response to treatment and prognosis in several malignancies. Less is known of the prevalence and clinical relevance of CTCs in esophagogastric adenocarcinoma, with the available data arising from heterogeneous patient populations using varied detection methods.
  
  
  METHODS
  A pilot study was undertaken to assess the prevalence of CTCs in patients with advanced esophageal or gastric adenocarcinoma. Patients were eligible if they had advanced disease and either had received no prior therapy or had progressed after prior chemotherapy. Blood samples for CTC analysis were obtained at baseline and during the course of treatment. The CellSearch immunomagnetic CTC detection platform was used.
  
  
  RESULTS
  Twenty-two patients with metastatic esophageal or gastric adenocarcinoma were enrolled. Eighteen received first-line EOX (epirubicin/oxaliplatin/capecitabine) chemotherapy (± panitumumab) and had baseline samples suitable for CTC analysis. At baseline, ≥ 2 CTCs were detected in 8 patients (44%). Overall tumor response rate was 60% in patients with < 2 CTCs and 37.5% in patients with ≥ 2 CTCs. Median progression-free and overall survival were 6.1 and 10.5 months and 5.2 and 6.1 months in the groups of patients with < 2 CTCs and ≥ 2 CTCs, respectively. The study was prematurely discontinued, owing to the withdrawal of commercial support.
  
  
  CONCLUSIONS
  The incidence of CTCs in locally advanced or metastatic esophagogastric cancer may be clinically relevant. Investigation of the potential clinical utility of CTCs is warranted in a larger cohort of patients with esophagogastric cancer.
authors: Department of Medicine, Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom. Electronic address: francesco.sclafani@rmh.nhs.uk.
authors: Francesco
authors: F
authors: Sclafani
authors: Department of Medicine, Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom.
authors: Elizabeth
authors: E
authors: Smyth
authors: Department of Medicine, Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom.
authors: David
authors: D
authors: Cunningham
authors: Department of Medicine, Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom.
authors: Ian
authors: I
authors: Chau
authors: Department of Medicine, Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom.
authors: Andrea
authors: A
authors: Turner
authors: Department of Medicine, Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom.
authors: David
authors: D
authors: Watkins
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology*; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D010865:Pilot Projects; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Biomarkers; CTCs; Chemotherapy; Esophageal cancer; Gastric cancer