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Open Access Highly Accessed Research article

Innovative method using circulating tumor cells for prediction of the effects of induction therapy on locally advanced non-small cell lung cancer

Shintaro Tarumi*, Masashi Gotoh, Yoshitaka Kasai, Natsumi Matsuura, Masaya Okuda, Tetsuhiko Go, Shinya Ishikawa and Hiroyasu Yokomise

Author Affiliations

Department of general thoracic, breast and Endocrinological surgery, Faculty of medicine Kagawa University, Kagawa, Japan

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Journal of Cardiothoracic Surgery 2013, 8:175  doi:10.1186/1749-8090-8-175

Published: 16 July 2013

Abstract

Background

The existence of circulating tumor cells (CTCs) in patients with lung cancer has been reported. The purpose of this study was to assess whether CTCs are predictive of the pathological effects of induction chemoradiotherapy for patients with non-small cell lung cancer.

Methods

Patients who underwent induction chemoradiotherapy followed by surgery were compared with those who underwent surgery alone. Peripheral and pulmonary venous blood samples from the involved lobe were collected intraoperatively, and the number of CTCs was counted using the CellSearch™ system, an epithelial cell adhesion molecule-based immunomagnetic technique.

Results

Of the 9 patients who underwent induction therapy, 4 achieved pathological CR, 4 achieved major response, and 1 achieved minor response. All patients who underwent induction therapy and surgery alone were negative for CTCs in peripheral blood. In the induction therapy group, 4 patients showing pathological CR were negative for CTCs in pulmonary venous blood (pvCTCs) and 5 showing major/minor response were positive (mean, 57.8 cells). The numbers of CTCs in patients showing major/minor response were significantly higher than those in patients showing pathological CR (p = 0.012, Mann–Whitney U test). All 6 patients undergoing surgery alone were positive for pvCTCs (mean, 207.5 cells), showing a significant difference from those undergoing induction therapy (p = 0.038).

Conclusions

The existence of CTCs in pulmonary venous blood reflects pathological non-CR, and therapeutic pathological response may be predicted by pvCTC measurement.

Keywords:
Circulating tumor cells; Non-small cell lung cancer; Induction chemoradiotherapy; Surgery; CellSearch