Prognostic value of integrating circulating tumour cells and cell-free DNA in non-small cell lung cancer
Joanna Kapeleris,
Juliana Müller Bark,
Shanon Ranjit,
Darryl Irwin,
Gunter Hartel,
Majid Ebrahimi Warkiani,
Paul Leo,
Connor O'Leary,
Rahul Ladwa,
Kenneth O'Byrne,
Brett G.M. Hughes,
Chamindie Punyadeera
Affiliations
Joanna Kapeleris
Queensland University of Technology, Faculty of Health, School of Biomedical Sciences, Centre for Biomedical Technologies, Saliva and Liquid Biopsy Translational Laboratory Kelvin Grove, QLD, Australia; Translational Research Institute, Woolloongabba, Brisbane, Australia
Juliana Müller Bark
Queensland University of Technology, Faculty of Health, School of Biomedical Sciences, Centre for Biomedical Technologies, Saliva and Liquid Biopsy Translational Laboratory Kelvin Grove, QLD, Australia; Translational Research Institute, Woolloongabba, Brisbane, Australia; Saliva and Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery, Griffith University, Brisbane, Australia
Shanon Ranjit
Queensland University of Technology, Faculty of Health, School of Biomedical Sciences, Centre for Biomedical Technologies, Saliva and Liquid Biopsy Translational Laboratory Kelvin Grove, QLD, Australia
Darryl Irwin
Agena Biosciences, Bowen Hills, Brisbane, QLD, Australia
Gunter Hartel
QIMR Berghofer Medical Research Institute, Herston Road, Herston, QLD, Australia
Majid Ebrahimi Warkiani
School of Biomedical Engineering, University of Technology Sydney, Sydney, Ultimo NSW, Australia
Paul Leo
Translational Research Institute, Woolloongabba, Brisbane, Australia; Australian Translational Genomics Centre, Queensland University of Technology, Faculty of Health, School of Biomedical Sciences, Woolloongabba, Australia
Connor O'Leary
Translational Research Institute, Woolloongabba, Brisbane, Australia; Department of Medical Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
Rahul Ladwa
Department of Medical Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; School of Medicine, University of Queensland, Herston, Brisbane, Queensland, Australia
Kenneth O'Byrne
Translational Research Institute, Woolloongabba, Brisbane, Australia; Department of Medical Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
Brett G.M. Hughes
School of Medicine, University of Queensland, Herston, Brisbane, Queensland, Australia; The Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia
Chamindie Punyadeera
Translational Research Institute, Woolloongabba, Brisbane, Australia; Saliva and Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery, Griffith University, Brisbane, Australia; Menzies Health Institute, Griffith University, Gold-Coast, Australia; Corresponding author.
Background: Non-small cell lung cancer (NSCLC) often presents at an incurable stage, and majority of patients will be considered for palliative treatment at some point in their disease. Despite recent advances, the prognosis remains poor, with a median overall survival of 12–18 months. Liquid biopsy-based biomarkers have emerged as potential candidates for predicting prognosis and response to therapy in NSCLC patients. This pilot study evaluated whether combining circulating tumour cells and clusters (CTCs) and cell-free DNA (cfDNA) can predict progression-free survival (PFS) in NSCLC patients. Methods: CTC and cfDNA/ctDNA from advanced stage NSCLC patients were measured at study entry (T0) and 3-months post-treatment (T1). CTCs were enriched using a spiral microfluidic chip and characterised by immunofluorescence. ctDNA was assessed using an UltraSEEK® Lung Panel. Kaplan-Meier plots were generated to investigate the contribution of the presence of CTC/CTC clusters and cfDNA for PFS. Cox proportional hazards analysis compared time to progression versus CTC/CTC cluster counts and cfDNA levels. Results: Single CTCs were found in 14 out of 25 patients, while CTC clusters were found in 8 out of the 25 patients at T0. At T1, CTCs were found in 7 out of 18 patients, and CTC clusters in 1 out of the 18 patients. At T0, CTC presence and the combination of CTC cluster counts with cfDNA levels were associated with shorter PFS, p = 0.0261, p = 0.0022, respectively. Conclusions: Combining CTC cluster counts and cfDNA levels could improve PFS assessment in NSCLC patients. Our results encourage further investigation on the combined effect of CTC/cfDNA as a prognostic biomarker in a large cohort of advanced stage NSCLC patients.
