Blood tumor load: combining biomarkers to increase the proportion of informative patients

IF 7.1 2区医学 Q1 ONCOLOGY

ESMO Open Pub Date : 2025-06-17 DOI:10.1016/j.esmoop.2025.105302

E. Dathathri , A. Nanou , F.-C. Bidard , S. Renault , J.-Y. Pierga , J. de Bono , L. Terstappen , F.A.W. Coumans

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引用次数: 0

Abstract

Background

The load of circulating tumor cells (CTC) and tumor-derived extracellular vesicles (tdEV) strongly correlates with poor clinical outcomes and can be used to evaluate treatment response and the presence of treatment targets. However, the frequency of CTC is low, making an accurate assessment impossible in most patients. Here, we introduce blood tumor load (BTL), in which CTC and tdEV are combined into one value ranging from 0 (low) to 1 (high) to simplify result interpretation and increase the percentage of patients from which a reliable assessment can be made.

Patients and methods

The CTC and tdEV counts were obtained from the ACCEPT analysis of the CellSearch image datasets of 98 metastatic breast cancer patients (mBC) and 157 castration-resistant prostate cancer patients (CRPC). The BTL generated using these counts was used in human epidermal growth factor receptor 2 (HER2) expression assessment in mBC patients. The BTL scores of CRPC patients at baseline and first follow-up time points were evaluated, and a change in BTL, indicating response to therapy, was measured in the patients.

Results

Using 10 CTCs as a threshold, the HER2 positivity could be determined in 34/98 (35%) breast cancer patients, whereas with BTL, the positivity increased to 76/98 (78%). The BTL showed an improved Cox hazard ratio for overall survival in 157 CRPC patients before and at first follow-up points compared with CTC and tdEV alone. A decrease in BTL indicating response to therapy was seen in 45% of CRPC patients, and an increase in BTL was seen in 9%, indicating progression on treatment. The remaining 46% of patients showed no change.

Conclusions

In this study, we demonstrated the applications of BTL in improving the reliability of measuring response to therapy and increasing the proportion of patients from which the presence of a treatment target can be assessed.

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血液肿瘤负荷：结合生物标志物增加信息性患者的比例

循环肿瘤细胞（CTC）和肿瘤源性细胞外囊泡（tdEV）的负荷与不良临床结果密切相关，可用于评估治疗反应和治疗靶点的存在。然而，CTC的发生频率较低，使得大多数患者无法进行准确的评估。在这里，我们引入血肿瘤负荷（BTL），其中CTC和tdEV合并为一个从0（低）到1（高）的值，以简化结果解释，并增加可以做出可靠评估的患者百分比。患者和方法对98例转移性乳腺癌（mBC）和157例去雄抵抗性前列腺癌（CRPC）的CellSearch图像数据集进行接受分析，获得CTC和tdEV计数。利用这些计数产生的BTL用于评估mBC患者的人表皮生长因子受体2 （HER2）表达。评估CRPC患者在基线和首次随访时间点的BTL评分，并测量患者BTL的变化，表明对治疗的反应。结果以10个ctc为阈值，34/98例（35%）乳腺癌患者HER2阳性，而BTL患者HER2阳性增加到76/98（78%）。与单独使用CTC和tdEV相比，BTL显示157例CRPC患者在首次随访前后总生存率的Cox风险比有所改善。45%的CRPC患者BTL下降表明对治疗有反应，9%的患者BTL增加表明治疗进展。其余46%的患者没有变化。结论：在本研究中，我们展示了BTL在提高测量治疗反应的可靠性和增加可以评估治疗目标存在的患者比例方面的应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ESMO Open Medicine-Oncology

CiteScore

11.70

自引率

2.70%

发文量

255

审稿时长

10 weeks

期刊介绍： ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research. ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO. Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.