Meta-analysis of Circulating Tumor Cells as a Prognostic Marker in Lung Cancer

Abstract Background Our study aimed to verify the prognostic value of circulating tumor cells (CTCs) prior to initial treatment on survival of non-small cell lung cancer (NSCLC) by using meta-analysis and system review of published studies. Materials and methods The PubMed, EMBASE and Cochrane Library were searched, respectively, to identify all studies that addressed the issues of CTCs prior to initial treatment and progression-free survival (PFS) and overall survival (OS). Finally, ten citations were included for analysis and assessment of publication bias by using review manager 5.3 statistical software and STATA 15.0. Results Randomized model analyzing multivariate Cox Proportional Hazards Regression indicated that higher abundance of CTCs significantly predicts poorer prognosis of lung cancer cases basing both on PFS (Z = 2.31, P = 0.02) and OS of advanced cases (Z = 2.44, P = 0.01), and systematic study aslo indicated the similar results. Conclusion High CTCs prior to initial treatment can predict shorter PFS and OS in NSCLC, and further studies are warranted in the future.

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Circulating tumor cells as a potential biomarker in diagnosis of lung cancer: a systematic review and meta-analysis

The Clinical Respiratory Journal ◽

10.1111/crj.12573 ◽

2016 ◽

Vol 12 (2) ◽

pp. 639-645 ◽

Cited By ~ 5

Author(s):

Huang Huang ◽

Yan Shi ◽

Jietao Huang ◽

Xiaohui Wang ◽

Rui Zhang ◽

...

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Tumor Cells ◽

Circulating Tumor Cells ◽

Meta Analysis ◽

Potential Biomarker ◽

Diagnosis Of Lung Cancer

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Correction: Prognostic Significance of Circulating Tumor Cells in Non-Small-Cell Lung Cancer Patients: A Meta-Analysis

PLoS ONE ◽

10.1371/annotation/6633ed7f-a10c-4f6d-9d1d-9c1245822eb7 ◽

2014 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Jianwei Wang ◽

Ke Wang ◽

Jianjun Xu ◽

Jian Huang ◽

Tao Zhang

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cancer Patients ◽

Tumor Cells ◽

Circulating Tumor Cells ◽

Meta Analysis ◽

Prognostic Significance ◽

Small Cell ◽

Small Cell Lung ◽

Lung Cancer Patients

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Circulating tumor cells as a prognostic marker in metastatic non-small-cell lung cancer patients receiving chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.11041 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 11041-11041 ◽

Cited By ~ 1

Author(s):

Yuichi Sakamori ◽

Young Hak Kim ◽

Hiroshige Yoshioka ◽

Masataka Hirabayashi ◽

Koichi Onaru ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Tumor Cells ◽

Circulating Tumor Cells ◽

Prognostic Marker ◽

Small Cell ◽

Small Cell Lung ◽

Time Points ◽

Metastatic Nsclc ◽

Radiographic Response

11041 Background: Radiographic response remains the gold standard for assessment of the chemotherapy effect and has been used as a surrogate endpoint in clinical trials. Recently, circulating tumor cells (CTC) have emerged as a novel prognostic marker in many types of cancer; however, their significance has not been fully examined in patients with non-small-cell lung cancer (NSCLC). Methods: We conducted a prospective study to evaluate the clinical significance of CTC in metastatic NSCLC patients treated with chemotherapy. Peripheral blood samples were collected for CTC analysis before chemotherapy, after 1 cycle of chemotherapy, and after 2 cycles of chemotherapy. CTC analysis was performed using CellSearch (Veridex). Results: One hundred and forty-eight patients wereenrolledbetween August 2009 and January 2012, and 121 patients were eligible for the analysis. CTC was positive (CTC ≥1) in 30.6% (37/121) before chemotherapy, in 21.0% (26/118) after 1 cycle of chemotherapy, and in 21.6% (24/111) after 2 cycles of chemotherapy, respectively. CTC counts were higher in patients with N3 lymph node metastases (vs. N0-2, p = 0.0001), M1b status (vs. M1a, p = 0.0081) or ≥2 metastasis sites (vs. 1 metastasis site, p = 0.0342). Although not statistically significant, a positive trend was observed between the radiographic response and the dynamic change of CTC counts (p = 0.0734). In multivariate analysis, including the radiographic response (responder vs. non-responder), baseline CTC was a significant negative predictive factor for PFS (HR = 1.867; p = 0.0080) and OS (HR = 2.753; p = 0.0006). Considering pre- and post-treatment time points (before and after 2 cycles of chemotherapy) together, CTC-positive patients at either time point experienced significantly worse PFS (HR = 1.747; p = 0.0143) and OS (HR = 2.031; p = 0.0123) than those who were CTC negative at both time points. Conclusions: CTC was an independent prognostic factor in patients with metastatic NSCLC who was treated with chemotherapy.

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Role of circulating tumor cells in diagnosis of lung cancer: a systematic review and meta-analysis

Journal of International Medical Research ◽

10.1177/0300060521994926 ◽

2021 ◽

Vol 49 (3) ◽

pp. 030006052199492

Author(s):

Qingtao Zhao ◽

Zheng Yuan ◽

Huien Wang ◽

Hua Zhang ◽

Guochen Duan ◽

...

Keyword(s):

Lung Cancer ◽

Diagnostic Accuracy ◽

Tumor Cells ◽

Circulating Tumor Cells ◽

Meta Analysis ◽

False Negative ◽

Cochrane Library ◽

True Negative ◽

Clinical Determination

Objective We systematically reviewed the literature relating to the diagnostic accuracy of circulating tumor cells (CTCs) for the clinical determination of lung cancer. Methods This meta-analysis aimed to evaluate the diagnostic accuracy of CTCs for the clinical determination of lung cancer. The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant studies up to 31 May 2020. The numbers of patients with true positive, false positive, false negative, and true negative results were extracted from each individual study. Pooled sensitivity, specificity, and area under the curve values were calculated with 95% confidence intervals (CI). Results Twenty-one studies with 3997 subjects met the inclusion criteria. The overall diagnostic accuracy was assessed. The pooled sensitivity and specificity were 0.72 (95%CI: 0.65–0.79) and 0.96 (95%CI: 0.91–0.98), respectively, and the pooled positive and negative likelihood ratios were 16.86 (95%CI: 7.65–37.12) and 0.29 (95%CI: 0.23–0.37), respectively. The combined diagnostic odds ratio was 58.12 (95%CI: 24.82–136.09). Conclusion This meta-analysis indicated that CTCs had good diagnostic value for detecting lung cancer.

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