Abstract
Hepatocellular carcinoma (HCC) is among the most common causes of cancer death in men. Whether or not a longitudinal follow-up of circulating tumor cells (CTCs) before and at different time points during systemic/targeted therapy is useful for monitoring the treatment response of patients with locally advanced or metastatic HCC has been evaluated in this study. Blood samples (n = 104) were obtained from patients with locally advanced or metastatic HCC (n = 30) for the enrichment of CTCs by a negative selection method. Analysis of the blood samples from patients with defined disease status (n = 81) revealed that those with progressive disease (PD, n = 37) had significantly higher CTC counts compared to those with a partial response (PR) or stable disease (SD; n = 44 for PR + SD, p = 0.0002). The median CTC count for patients with PD and for patients with PR and SD was 50 (interquartile range 21–139) and 15 (interquartile range 4–41) cells/mL of blood, respectively. A longitudinal analysis of patients (n = 17) after a series of blood collections demonstrated that a change in the CTC count correlated with the patient treatment response in most of the cases and was particularly useful for monitoring patients without elevated serum alpha-fetoprotein (AFP) levels. Sequential CTC enumeration during treatment can supplement standard medical tests and benefit the management of patients with locally advanced or metastatic HCC, in particular for the AFP-low cases.
Highlights
The absolute incidence and mortality of hepatocellular carcinoma (HCC) worldwide reported in 2018 was 841,080 and 781,631, respectively [1]
Hepatitis B virus (HBV)/hepatitis C virus (HCV) infection and alcohol abuse are among the major etiologies for liver diseases and cancer
Whether or not serial circulating tumor cells (CTCs) counts during the course of treatment provides an advantage for monitoring the treatment response and disease status of patients with HCC remains to be explored
Summary
The absolute incidence and mortality of hepatocellular carcinoma (HCC) worldwide reported in 2018 was 841,080 and 781,631, respectively [1]. Effective therapies that reduce tumor burden usually correlates with a decrease in the number of CTCs. Monitoring the CTC count is valuable in scrutinizing the treatment response of cancer patients and should provide for better patient care and management [12,13,14]. Whether or not serial CTC counts during the course of treatment provides an advantage for monitoring the treatment response and disease status of patients with HCC remains to be explored. By the PowerMag platform, the number of CTCs and the change in the CTC counts were analyzed and correlated with the disease status and treatment response of the patients. Performing a series of CTC enumeration in parallel with the current standard medical methods provide benefits for the clinical care of patients with locally advanced or metastatic HCC, in particular for patients without elevated serum AFP levels
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