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Annals of Oncology Advance Access originally published online on October 3, 2008
Annals of Oncology 2009 20(2):305-308; doi:10.1093/annonc/mdn627
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

urogenital tumors

Detection of circulating tumor cells in patients with urothelial cancer

D. J. Gallagher1, M. I. Milowsky1,*, N. Ishill2, A. Trout1, M. G. Boyle1, J. Riches1, M. Fleisher3 and D. F. Bajorin1

1 Genitourinary Oncology Service, Division of Solid Tumor Oncology, Department of Medicine
2 Department of Epidemiology and Biostatistics
3 Department of Clinical Laboratories, Memorial Sloan-Kettering Cancer Center and Joan and Sanford Weill Medical College of Cornell University, New York, USA

* Correspondence to: Dr M. I. Milowsky, Genitourinary Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA. Tel: +1-646-422-4461; Fax: +1-212-988-0683; E-mail: milowskm{at}mskcc.org

Background: Approximately 50% of patients with metastatic urothelial cancer (UC) respond to chemotherapy and several months of therapy is required to assess for radiographic response. Blood-based biomarkers may identify patients in whom a specific therapy provides clinical benefit, and this study sought to characterize circulating tumor cells (CTCs) in patients with metastatic UC.

Patients and methods: Peripheral blood from patients with metastatic UC was evaluated for CTCs using the CellSearch system. We assessed for associations between CTC counts and the number and sites of metastatic disease.

Results: CTC evaluations were carried out in 33 patients with metastatic UC. Fourteen of 33 patients (44%; 95% confidence interval 27% to 59%) had a positive assay (range 0–87 cells/7.5 ml of blood) with 10 patients (31%) having five or more CTCs. A significantly higher number of CTCs was seen in patients with two or more sites of metastases compared with those with less than one or one site of metastases (3.5 versus 0, P = 0.04).

Conclusions: CTCs, detected by antibody capture technology, are present in 44% of patients with metastatic UC. Higher numbers of CTCs are seen in patients with a greater number of metastatic sites. One-third of patients have five or more CTCs providing a potential early marker to monitor response to chemotherapy.

Key words: bladder cancer, circulating tumor cells, urothelial cancer

Received for publication May 23, 2008. Revision received July 10, 2008. Accepted for publication August 7, 2008.


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