Dynamic evaluation of circulating tumour cells in patients with advanced gastric and oesogastric junction adenocarcinoma: Prognostic value and early assessment of therapeutic effects

Simon Pernot (1, 2) , Cecile Badoual (3, 2) , Magali Terme (2) , Florence Castan (4) , Aurelie Cazes (3) , Olivier Bouche (5) , Jaafar Bennouna (6) , Eric Francois (7) , Francois Ghiringhelli (8) , Christelle de La Fouchardiere (9) , Emmanuelle Samalin (10) , Jean Baptiste Bachet (11) , Christophe Borg (12) , Michel Ducreux (13, 14) , Elie Marcheteau (2) , Trevor Stanbury (15) , Sophie Gourgou (4) , David Malka (13) , Julien Taieb (2)

1 Service de Biochimie - Unité Fonctionnelle de Pharmacogénétique et Oncologie Moléculaire [AP-HP Hôpital Européen Georges Pompidou]
2 PARCC - UMR-S U970 - Paris-Centre de Recherche Cardiovasculaire
3 Centre de Ressources biologiques - Service d’anatomo‑pathologie [AP-HP Hôpital Européen Georges Pompidou]
4 IRCM - U1194 Inserm - UM - Institut de Recherche en Cancérologie de Montpellier
5 CHU Reims - Centre Hospitalier Universitaire de Reims
6 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
7 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
8 UNICANCER/CRLCC-CGFL - Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon]
9 Centre Léon Bérard [Lyon]
10 CRLC Val d'Aurelle-Paul Lamarque
11 CHU Pitié-Salpêtrière [AP-HP]
12 Service d'Oncologie Médicale [CHRU Besançon]
13 IGR - Institut Gustave Roussy
14 Oncologie digestive
15 ICM - UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle

Background: The identification of dynamic biomarkers in advanced gastric and oesogastric junction adenocarcinoma (GOA) could help to tailor strategies for each patient. Enumeration of circulating tumour cells (CTCs) is approved by the US Food and Drug Administration in breast, colon and prostate cancer but is not in advanced GOA. Our study aims to establish the optimal threshold and the clinical significance of CTC count in advanced GOA before and during treatment. Methods: One hundred six patients with untreated advanced GOA were included in the ancillary study of the PRODIGE 17-ACCORD 20 trial. CTCs were detected in the peripheral blood using the CellSearch system on day 0 (D0) and day 28 (D28). The prognostic value of CTCs at D0 and D28 was analysed by testing several thresholds. Results: At baseline, median CTC count was 1 (range, 0-415). While CTCs >= 1, 2 or 3 at D0 were all significantly associated with worse overall survival (OS) and progression-free survival (PFS), CTCs >2 were the optimal threshold, on D0 or D28. CTCs >2 at D28 were also predictive of disease control. Taking into account both D0 and D28 CTC count defined 3 groups (low/low, high/low and low-high/high) with significantly different PFS (p = 0.0002) and OS (p = 0.003). Conclusion: Quantification of CTCs at baseline and during treatment may be a useful prognostic tool in advanced GOA, as it is associated with worse PFS and OS. A threshold >= 2 CTCs seems to have the best discriminant value. Change in CTC count between baseline and D28 could help to tailor treatment to each individual patient. (C) 2017 Elsevier Ltd. All rights reserved.

Mots clés: Biomarkers; Circulating tumour cells; Clinical trial; Prognosis; Stomach neoplasms

Domaines: Sciences du Vivant [q-bio]; Cancer

Simon Pernot, Cecile Badoual, Magali Terme, Florence Castan, Aurelie Cazes, et al.. Dynamic evaluation of circulating tumour cells in patients with advanced gastric and oesogastric junction adenocarcinoma: Prognostic value and early assessment of therapeutic effects. European Journal of Cancer, 2017, 79 (8), pp.15-22. ⟨10.1016/j.ejca.2017.03.036⟩. ⟨hal-01579145⟩