Early Detection of Recurrence in Patients With Locally Advanced Non-Small-Cell Lung Cancer via Circulating Tumor Cell...

Area of Science:

• Oncology
• Molecular Diagnostics
• Cancer Biomarkers

Background:

• Circulating tumor cell (CTC) assays offer noninvasive monitoring for lung cancer.
• Serial CTC analysis may complement imaging for detecting recurrences in locally advanced non-small-cell lung cancer (LA-NSCLC).

Purpose of the Study:

• To investigate if serial CTC analysis can detect recurrences after chemoradiation in LA-NSCLC patients.
• To assess if CTC detection precedes conventional imaging for recurrence detection.

Main Methods:

• Prospective enrollment of LA-NSCLC patients (stage II-III) treated with concurrent chemoradiation.
• CTC identification using an adenoviral probe detecting telomerase activity in peripheral blood.
• Defined "detectable" CTC level as 1.3 GFP-positive cells/mL; collected samples pre-, during, and post-treatment (up to 24 months).

Main Results:

• 48 patients enrolled; 22 (46%) experienced recurrence at a median of 7.6 months post-treatment.
• Of 20 patients with post-RT samples, 15 (75%) showed increased CTC counts.
• In 10 patients, increased CTCs preceded radiographic recurrence by a median of 6.2 months.

Conclusions:

• Longitudinal CTC monitoring is feasible in LA-NSCLC patients post-chemoradiation.
• Detectable CTC levels often precede radiologic evidence of disease recurrence, suggesting a valuable role in monitoring.