Abstract
Purpose
Standardized enumeration of CEC counts is required to minimize variability and allow cross-studies comparisons. The purpose of this paper is to identify CEC threshold proposal, by CellSearch system, for determining response to bevacizumab-based chemotherapy in metastatic colorectal cancer.
Methods
From July 2007 to June 2008, 33 patients treated with FOLFOX4 plus bevacizumab were enrolled in a prospective study. From January 2007 to June 2007, before bevacizumab was approved by the government in Japan, 31 patients treated with FOLFOX4 as a control were enrolled. CECs of whole blood at the baseline, day 4, 2 weeks after initiation of chemotherapy were isolated and counted using CellSearch system.
Results
There was no correlation between CEC levels and the outcome in the FOLFOX4. In the bevacizumab-based chemotherapy, CEC levels at the baseline were significantly associated with the outcome. Patients with 65 or more CECs at the baseline had a shorter median PFS and OS, than the median PFS and OS of less than 65 CECs at the baseline in the bevacizumab-based chemotherapy (P = 0.003, P = 0.027, respectively). By univariate and multivariate Cox proportional-hazards regression, CEC levels (cut-off; 65) at the baseline indicated the strongest predictor for the outcome to bevacizumab-based chemotherapy.
Conclusion
A threshold of lower than 65 CECs, by the CellSearch System, at the baseline was a significant predictor of the outcome for colorectal cancer patients treated with bevacizumab-based chemotherapy.
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Acknowledgments
This work was supported by AstraZeneca Research Grant 2007, the Kobayashi Institute for Innovative Cancer Chemotherapy, and a Grant-in-Aid for Scientific Research (Japan Society for the Promotion of Science) (grant number 19790963, 21591741, 17016077). The excellent technical assistances of Sayuri Minowa, Harumi Shibata, and Mariko Kimura are greatly appreciated.
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Matsusaka, S., Suenaga, M., Mishima, Y. et al. Circulating endothelial cells predict for response to bevacizumab-based chemotherapy in metastatic colorectal cancer. Cancer Chemother Pharmacol 68, 763–768 (2011). https://doi.org/10.1007/s00280-010-1543-2
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DOI: https://doi.org/10.1007/s00280-010-1543-2