Prognostic impact and potential predictive role of baseline circulating tumor cells in locally advanced head and neck squamous cell carcinoma

Author(s)

de Oliveira, Thiago Bueno ^[1] ; Braun, Alexcia Camila ^[2] ; Nicolau, Ulisses Ribaldo ^[1] ; Abdallah, Emne Ali ^[2] ; Alves, Vanessa da Silva ^[2] ; Fonseca de Jesus, Victor Hugo ^[1] ; Calsavara, Vinicius Fernando ^[3] ; Kowaslki, Luiz Paulo ^[4] ; Domingos Chinen, Ludmilla T. ^[2]

Affiliation

^[1] AC Camargo Canc Ctr, Med Oncol Dept, Sao Paulo - Brazil

^[2] AC Camargo Canc Ctr, Int Res Ctr, Sao Paulo - Brazil

^[3] AC Camargo Canc Ctr, Epidemiol & Stat, Int Res Ctr, Sao Paulo - Brazil

^[4] AC Camargo Canc Ctr, Head & Neck Surg & Otorhinolaryngol Dept, Sao Paulo - Brazil

• Document type: Journal article
• Source: Oral Oncology; v. 121, OCT 2021.
• Web of Science Citations: 0

Abstract

Objectives: The prognostic impact of circulating tumor cells (CTCs) or circulating tumor microemboli (CTM) in locally advanced head and neck squamous cell carcinoma (LA-HNSCC) is yet to be determined, with conflicting results in previous trials. The role of induction chemotherapy (ICT) in the management of LA-HNSCC is controversial with no predictive biomarkers to guide treatment strategy in this scenario. The aim of this trial is to determine the prognostic impact of CTCs and CTM, their biomarkers expression by immunocytochemistry (ICC), and its potential role as predictors of ICT benefit in LA-HNSCC. Materials and Methods: Prospective study, with newly diagnosed stage III/IV non-metastatic LA-HNSCC patients treated with curative intent. Blood samples analyzed for CTCs and CTM before treatment using the ISET method. Results: A total of 83 patients were included. CTCs counts were an independent prognostic factor for overall survival (OS; HR: 1.17; 95 %CI: 1.05-1.31; p = 0.005) and progression free survival (PFS; HR:1.14; 95 %CI: 1.03-1.26; p = 0.007). Using the Lausen and Schumacher technique, 2.8 CTCs/mL for OS and 3.8 CTCs/mL for PFS were defined as the best cut-offs. CTM were detected in 27.7% of patients, correlating with worse PFS (HR = 2.70; IC95%: 1.30-5.58; p = 0.007). MRP-7 expression in CTM correlated with worse OS (HR = 3.49; 95 %CI: 1.01-12.04; p = 0.047) and PFS (HR = 3.62; 95 %CI: 1.08-12.13; p = 0.037). CTCs counts were predictive of complete response to treatment (OR = 0.74; 95 %CI: 0.58-0.95; p = 0.022) and high counts (cut-off 3.8/mL) and CTM were potential predictors of ICT benefit. Conclusion: CTCs/CTM had significant prognostic impact and potential role as predictors of ICT benefit in LA-HNSCC. (AU)

• FAPESP's process: 13/08125-7 - Detection of circulating tumor cells and their correlation with clinical evolution in epidermoid carcinoma of head and neck
• Grantee: Ludmilla Thomé Domingos Chinen
• Support Opportunities: Regular Research Grants