Circulating tumor cells in advanced non-small cell lung cancer patients are associated with worse tumor response to checkpoint inhibitors

Non-small cell lung cancer (NSCLC) patients treated with checkpoint inhibitors show long lasting responses, but it is hard to predict which patients will profit from this treatment with the currently used marker, programmed death ligand 1 (PD-L1). We hypothesized that circulating tumor cells (CTC) o...

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Bibliographic Details
Published in:Journal for immunotherapy of cancer 2019-07, Vol.7 (1), p.173-173, Article 173
Main Authors: Tamminga, Menno, de Wit, Sanne, Hiltermann, T Jeroen N, Timens, Wim, Schuuring, Ed, Terstappen, Leon W M M, Groen, Harry J M
Format: Article
Language:English
Subjects:
Cancer
Cancer cells
Cancer metastasis
Cancer treatment
Care and treatment
Checkpoint inhibitors
Circulating tumor cells (CTC)
Death
Durable response
Immune response
Immunotherapy
Lung cancer
Medical prognosis
Medical research
Metastasis
Non-small cell lung cancer
Non-small cell lung cancer (NSCLC)
Regression analysis
Response rates
Small cell lung cancer
Tumor derived extracellular vesicles (tdEV)
Tumors
Variables
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Summary:Non-small cell lung cancer (NSCLC) patients treated with checkpoint inhibitors show long lasting responses, but it is hard to predict which patients will profit from this treatment with the currently used marker, programmed death ligand 1 (PD-L1). We hypothesized that circulating tumor cells (CTC) or tumor derived extracellular vesicles (tdEV) are markers of treatment efficacy. Patients with advanced NSCLC treated with checkpoint inhibitors were included. Blood was drawn at baseline (T0) and at 4 weeks of treatment (T1) for analysis of CTC and tdEV using CellSearch®. Tumor response was classified as partial or complete response based on the response evaluation criteria in solid tumors (RECISTv1.1) measured 4-6 weeks after start of treatment. Durable response was defined as stable disease, partial or complete response without disease progression at 6 months. Analyses were adjusted for covariables including PD-L1 expression. We included 104 patients (30 with a tumor response, 74 non-responders, 2 responses not evaluable due to early death); 63 patients provided T1 samples. All patients were treated with PD-L1 inhibitors. The majority of patients received second (85%) or third line (treatment with nivolumab monotherapy (89%). CTC were present in 33/104 patients at T0 (32%) and 17/63 at T1 (27%), 9/63 patients had CTC (14%) at both time points. The presence of CTC, both at T0 (OR = 0.28, p = 0.02,) and T1 (OR = 0.07, p 
ISSN:2051-1426
2051-1426
DOI:10.1186/s40425-019-0649-2