Abstract
Background
Circulating tumor cells (CTCs) are closely associated with hepatocellular carcinoma (HCC) progression, but the value of CTCs in systemic treatment remains to be explored.
Methods
One hundred and twenty-five patients with advanced HCC who underwent systemic treatment were included in the study. Five millilitre peripheral blood were drawn before treatment, one month, three months, six months, and one year after systemic treatment. isolation by size of epithelial tumor cells (ISET) is used to capture circulating tumor cells. The tumor response to systemic treatment was assessed by modified response evaluation criteria in solid tumors criteria (mRECIST). The correlation between the dynamic change of peripheral blood CTCs level and tumor response to systemic treatment was analysis.
Results
The objective response rate (ORR) and disease control rate (DCR) were 39.2% (49/125) and 82.4% (103/125) respectively. Dynamic CTCs analysis showed that the CTCs levels of patients with (progressive disease) PD status continued to be at a high level and gradually increased. The CTCs levels of patients in complete response (CR), partial response (PR), and stable disease (SD) status gradually decreased as treatment continued. Patients with higher initial CTCs levels have worse tumor treatment response. Patients with less than 15 initial CTCs, less than 13 CTCs in the first month, and less than 10 CTCs in the third month are more likely to achieve objective response and have a better response to tumor treatment. The PFS and OS were better than those of patients with more than 15 initial CTCs, more than 13 CTCs in the first month, and more than 10 CTCs in the third month.
Conclusions
The number of CTCs in peripheral blood is closely related to tumor treatment response in patients with advanced HCC. Detecting the number of CTCs in patients has important clinical significance in predicting tumor treatment response and evaluating patient prognosis.