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. 2021 Jun 13;13(12):2966.
doi: 10.3390/cancers13122966.

Clinical Relevance of Viable Circulating Tumor Cells in Patients with Metastatic Colorectal Cancer: The COLOSPOT Prospective Study

Thibault Mazard  1   2 , Laure Cayrefourcq  3   4 , Françoise Perriard  5 , Hélène Senellart  6 , Benjamin Linot  7 , Christelle de la Fouchardière  8 , Eric Terrebonne  9 , Eric François  10 , Stéphane Obled  11 , Rosine Guimbaud  12 , Laurent Mineur  13 , Marianne Fonck  14 , Jean-Pierre Daurès  5 , Marc Ychou  1 , Eric Assenat  2 , Catherine Alix-Panabières  3   4
Affiliations

Clinical Relevance of Viable Circulating Tumor Cells in Patients with Metastatic Colorectal Cancer: The COLOSPOT Prospective Study

Thibault Mazard et al. Cancers (Basel). .

Abstract

Background: Circulating tumor cells (CTCs) allow the real-time monitoring of tumor course and treatment response. This prospective multicenter study evaluates and compares the early predictive value of CTC enumeration with EPISPOT, a functional assay that detects only viable CTCs, and with the CellSearch® system in patients with metastatic colorectal cancer (mCRC).

Methods: Treatment-naive patients with mCRC and measurable disease (RECIST criteria 1.1) received FOLFIRI-bevacizumab until progression or unacceptable toxicity. CTCs in peripheral blood were enumerated at D0, D14, D28, D42, and D56 (EPISPOT assay) and at D0 and D28 (CellSearch® system). Progression-free survival (PFS) and overall survival (OS) were assessed with the Kaplan-Meier method and log-rank test.

Results: With the EPISPOT assay, at least 1 viable CTC was detected in 21% (D0), 15% (D14), 12% (D28), 10% (D42), and 12% (D56) of 155 patients. PFS and OS were shorter in patients who remained positive, with viable CTCs between D0 and D28 compared with the other patients (PFS = 7.36 vs. 9.43 months, p = 0.0161 and OS = 25.99 vs. 13.83 months, p = 0.0178). The prognostic and predictive values of ≥3 CTCs (CellSearch® system) were confirmed.

Conclusions: CTC detection at D28 and the D0-D28 CTC dynamics evaluated with the EPISPOT assay were associated with outcomes and may predict response to treatment.

Keywords: CellSearch® system; EPISPOT assay; circulating tumor cells; colorectal cancer; predictive value.

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Conflict of interest statement

C.A.P. has received an honorarium from Menarini. T.M. discloses research funding from ROCHE and AMGEN; an honorarium from AMGEN, SANOFI, BMS, SANDOZ, and AAA; and travel, accommodations, and expenses paid by AMGEN. The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart showing the number of included patients and the number of patients in whom CTCs could be assessed in peripheral blood samples at different time points before (D0) and during treatment (EPISPOT: D14, D28, D42, D56; CellSearch®: D28). Abbreviations: N, number; D, day.
Figure 2
Figure 2
PFS and OS in patients with metastatic CRC at D28. CTCs were enumerated after the first two chemotherapy cycles (D28) with the (A,B) CK19-EPISPOT (≥2 vs. <2) and (C,D) CellSearch® (≥3 vs. <3) assays.
Figure 3
Figure 3
PFS and OS in metastatic CRCs according to the D0–D28 CTC kinetics. Patients were divided into two groups in the function of CTC enumeration at D0 and D28, using the (A,B) CK19-EPISPOT and (C,D) CellSearch® assays.
See this image and copyright information in PMC

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