CK-19 mRNA-positive cells in peripheral blood predict treatment efficacy and survival in small-cell lung cancer patients

• Published in: Medical oncology (Northwood, London, England) London, England), 2013-12, Vol.30 (4), p.755-755, Article 755
• Main Authors: Shi, Wei-Lin, Li, Jian, Du, Yong-Jie, Zhu, Wen-Fang, Wu, Yan, Hu, Yi-Ming, Chen, Yong-Chang
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Agents - therapeutic use; Case-Control Studies; Female; Hematology; Humans; Internal Medicine; Kaplan-Meier Estimate; Keratin-19 - blood; Keratin-19 - genetics; Keratin-19 - metabolism; Lung cancer; Lung Neoplasms - blood; Lung Neoplasms - drug therapy; Lung Neoplasms - metabolism; Lung Neoplasms - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Neoplastic Cells, Circulating - metabolism; Oncology; Original Paper; Pathology; RNA, Messenger - blood; RNA, Messenger - genetics; RNA, Messenger - metabolism; Small Cell Lung Carcinoma - blood; Small Cell Lung Carcinoma - drug therapy; Small Cell Lung Carcinoma - metabolism; Small Cell Lung Carcinoma - pathology; Treatment Outcome
• ISSN: 1357-0560; 1559-131X
• DOI: 10.1007/s12032-013-0755-9

Small-cell lung caner (SCLC) is the most aggressive form of lung cancer. The aim of this study was to investigate whether the presence of cytokeratin-19 (CK-19) mRNA-positive circulating tumor cells (CTCs) predicts treatment response, progression-free survival (PFS), and overall survival (OS) in SCLC patients who received standard therapy. Fifty-five SCLC patients were enrolled in this single-center prospective study. CK-19 mRNA-positive CTCs in blood samples were detected using real-time quantitative-PCR assay before the initiation of chemotherapy (B0) and after one chemotherapy cycle (B1) and three chemotherapy cycles (B3). The association with known prognostic factors and the effect of CK-19 mRNA-positive CTCs on patients’ prognosis were analyzed. Patients with positivity for CK-19 mRNA-positive CTCs at B0, B1, and B3 time points had shorter PFS and OS compared with patients without ( P  = 0.014 and P  = 0.01, respectively, at B0; P  = 0.008 and P  = 0.002, respectively, at B1; P  = 0.003 and P  = 0.001, respectively, at B3). Conversion of initial positivity for CK-19 mRNA-positive CTCs to negativity at B1 and B3 time points was associated with longer PFS and OS compared with patients with persistent positivity at three time points ( P  = 0.008 and P  = 0.010, respectively). Multivariate analysis demonstrated that the presence of CK-19 mRNA-positive CTCs at B0, B1, and B3 time points remained strong predictors of PFS and OS after adjustment for clinically significant factors. In conclusion, detection of CK-19 mRNA-positive CTCs before and during chemotherapy is an accurate indication of subsequent disease progression and mortality for SCLC patients.