Quantitative assessment of circulating tumor cells in cerebrospinal fluid as a clinical tool to predict survival in leptomeningeal metastases Journal Article

   

Authors:	Diaz, M.; Singh, P.; Kotchetkov, I. S.; Skakodub, A.; Meng, A.; Tamer, C.; Young, R. J.; Reiner, A. S.; Panageas, K. S.; Ramanathan, L. V.; Pentsova, E.
Article Title:	Quantitative assessment of circulating tumor cells in cerebrospinal fluid as a clinical tool to predict survival in leptomeningeal metastases
Abstract:	Purpose: Circulating tumor cells in cerebrospinal fluid are a quantitative diagnostic tool for leptomeningeal metastases from solid tumors, but their prognostic significance is unclear. Our objective was to evaluate CSF-CTC quantification in predicting outcomes in LM. Methods: This is a single institution retrospective study of patients with solid tumors who underwent CSF-CTC quantification using the CellSearch® platform between 04/2016 and 06/2019. Information on neuroaxis imaging, CSF results, and survival was collected. LM was diagnosed by MRI and/or CSF cytology. Survival analyses were performed using multivariable Cox proportional hazards modeling, and CSF-CTC splits associated with survival were identified through recursive partitioning analysis. Results: Out of 290 patients with CNS metastases, we identified a cohort of 101 patients with newly diagnosed LM. In this group, CSF-CTC count (median 200 CTCs/3 ml) predicted survival continuously (HR = 1.005, 95% CI: 1.002–1.009, p = 0.0027), and the risk of mortality doubled (HR = 2.84, 95% CI: 1.45–5.56, p = 0.0023) at the optimal cutoff of ≥ 61 CSF-CTCs/3 ml. Neuroimaging findings of LM (assessed by 3 independent neuroradiologists) were associated with a higher CSF-CTC count (median CSF-CTCs range 1.5–4 for patients without radiographic LM vs 200 for patients with radiographic LM, p < 0.001), but did not predict survival. Conclusion: Our data shows that CSF-CTCs quantification predicts survival in newly diagnosed LM, and outperforms neuroimaging. CSF-CTC analysis can be used as a prognostic tool in patients with LM and provides quantitative assessment of disease burden in the CNS compartment. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Keywords:	biomarker; circulating tumor cells; brain metastases; leptomeningeal metastases
Journal Title:	Journal of Neuro-Oncology
Volume:	157
Issue:	1
ISSN:	0167-594X
Publisher:	Springer
Date Published:	2022-03-01
Start Page:	81
End Page:	90
Language:	English
DOI:	10.1007/s11060-022-03949-1
PUBMED:	35113288
PROVIDER:	scopus
PMCID:	PMC9119011
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85124235511&doi=10.1007%2fs11060-022-03949-1&partnerID=40&md5=984f52b25466e31cf26441e54798b738
Notes:	Article -- Export Date: 1 April 2022 -- Funding details: National Institutes of Health, NIH, P30-CA008748 -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/197340