Circulating tumor cells criteria (CyCAR) versus standard RECIST criteria for treatment response assessment in metastatic colorectal cancer patients

Mayte Delgado-Ureña, Francisco G. Ortega, Diego Miguel-Pérez, Alba Rodriguez-Martínez, Jose L. García-Puche, Hugh Ilyine, Jose A. Lorente, Jose Exposito-Hernandez, M. Carmen Garrido-Navas, Miguel Delgado-Ramirez, M. José Serrano

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20 Scopus citations

Abstract

Background: The use of circulating tumor cells (CTCs) as indicators of treatment response in metastatic colorectal cancer (mCRC) needs to be clarified. The objective of this study is to compare the Response Evaluation Criteria in Solid Tumors (RECIST) with the Cytologic Criteria Assessing Response (CyCAR), based on the presence and phenotypic characterization of CTCs, as indicators of FOLFOX-bevacizumab treatment response. Methods: 77mCRC blood samples from FOLFOX-bevacizumab treated patients were analyzed to isolate CTCs before and after (12 and 24weeks) treatment, using an immunomagnetic separation method. VEGFR expression was identified by double immunostaining. Results: We observed a decrease of CTCs (42.8 vs. 18.2%) and VEGFR positivity (69.7% vs. 41.7%) after treatment. According to RECIST, 6.45% of the patients did not show any clinical benefit, whereas 93.55% patients showed a favorable response at 12weeks. According to CyCAR, 29% had a non-favorable response and 71% patients did not. No significant differences were found between the response assessment by RECIST and CyCAR at 12 or 24weeks. However, in the multivariate analysis, RECIST at 12weeks and CyCAR at 24weeks were independent prognostic factors for OS (HR: 0.1, 95% CI 0.02-0.58 and HR: 0.35, 95% CI 0.12-0.99 respectively). Conclusions: CyCAR results were comparable to RECIST in evaluating the response in mCRC and can be used as an alternative when the limitation of RECIST requires additional response analysis techniques.

Original languageEnglish
Article number251
JournalJournal of Translational Medicine
Volume16
Issue number1
DOIs
StatePublished - 6 Sep 2018
Externally publishedYes

Keywords

  • Bevacizumab
  • Circulating tumor cells
  • CyCAR
  • Metastatic colorectal cancer
  • Prognosis
  • RECIST

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