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Predictive and prognostic value of circulating endothelial cells in non-small cell lung cancer patients treated with standard chemotherapy

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

Monitoring circulating endothelial cells (CECs) count reflects the tumor vasculature in cancer patients and might be a predictor of response to chemotherapy. We therefore investigated the clinical significance of changes in CECs count after three cycles of platinum-based chemotherapy in patients with advanced non-small cell lung cancer (NSCLC).

Methods

Peripheral blood samples were collected from 89 naive NSCLC patients at diagnosis and after chemotherapy. The CECs were quantified by an immuno-magnetic technique and fluorescent microscopy. After chemotherapy, patients were assessed according to the response evaluation criteria in solid tumors as partial response (PR), stable disease (SD) or progression disease (PD).

Results

Baseline CECs levels were significantly higher in PR patients (n = 62) than those in patients with SD/PD (n = 27) (p = 0.0007). Although there was no significant correlation between baseline CECs levels and progression-free survival (PFS) (p = 0.287), patients with high percentage change in CECs count after chemotherapy had significantly longer PFS than those with low percentage change (p = 0.048). Regarding treatment efficacy, CECs count significantly decreased after chemotherapy in comparison with CECs count at baseline in patients with PR (p < 0.0001). By contrast, CECs levels after chemotherapy were significantly higher than those at diagnosis in patients with PD (p = 0.002). Moreover, there was no significant change between pre- and post-treatment CECs amount in patients with SD (p = 0.681).

Conclusions

Baseline CECs levels might be an early predictive biomarker for treatment efficacy in advanced NSCLC patients. Our results suggest the change in CECs count after chemotherapy as a prognostic factor for tumor response and PFS in NSCLC.

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Acknowledgments

The preliminary results of this study were in part presented at the 38th meeting of European cancer congress (Amsterdam, The Netherland, September 27, 2013). The first author would like to thank Pr. I Othman, Director General of AECS, for his cooperation in this project. The authors also thank Ms. Israa Banat for technical assistance and Mr. Ali Mohammad for his aide in statistical analyses.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Biomarkers Laboratory, Department of Radiation Medicine, Atomic Energy Commission of Syria (AECS), P.O. Box 6091, Damascus, Syria

    Fadi Najjar, Nissreen Almalla, Moaz Altahan & Ghassan Al-Massarani

  2. Division of Thoracic Oncology, Department of Oncology, Albairouni University Hospital, Damascus, Syria

    Moosheer Alammar & Marroan Bachour

  3. Department of Diagnostic Radiology, Albairouni University Hospital, Damascus, Syria

    Ali Alali

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  1. Fadi Najjar
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  2. Moosheer Alammar
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  3. Marroan Bachour
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  4. Nissreen Almalla
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  5. Moaz Altahan
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  6. Ali Alali
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  7. Ghassan Al-Massarani
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Correspondence to Fadi Najjar.

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Najjar, F., Alammar, M., Bachour, M. et al. Predictive and prognostic value of circulating endothelial cells in non-small cell lung cancer patients treated with standard chemotherapy. J Cancer Res Clin Oncol 141, 119–125 (2015). https://doi.org/10.1007/s00432-014-1778-0

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  • DOI: https://doi.org/10.1007/s00432-014-1778-0

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