Tumour-derived extracellular vesicles in blood of metastatic cancer patients associate with overall survival
Menée à partir de l'analyse par microscopie en fluorescence d'échantillons sanguins prélevés sur 956 patients atteints d'un cancer de la prostate résistant à la castration, d'un cancer colorectal métastatique, d'un cancer du sein métastatique ou d'un cancer du poumon non à petites cellules, cette étude évalue, par rapport au comptage des cellules tumorales circulantes, l'intérêt d'énumérer les vésicules extracellulaires tumorales pour prédire la survie globale
Background : Circulating tumour cells (CTCs) in blood associate with overall survival (OS) of cancer patients, but they are detected in extremely low numbers. Large tumour-derived extracellular vesicles (tdEVs) in castration-resistant prostate cancer (CRPC) patients are present at around 20 times higher frequencies than CTCs and have equivalent prognostic power. In this study, we explored the presence of tdEVs in other cancers and their association with OS.
Methods : The open-source ACCEPT software was used to automatically enumerate tdEVs in digitally stored CellSearch® images obtained from previously reported CTC studies evaluating OS in 190 CRPC, 450 metastatic colorectal cancer (mCRC), 179 metastatic breast cancer (MBC) and 137 non-small cell lung cancer (NSCLC) patients before the initiation of a new treatment.
Results : Presence of unfavourable CTCs and tdEVs is predictive of OS, with respective hazard ratios (HRs) of 2.4 and 2.2 in CRPC, 2.7 and 2.2 in MBC, 2.3 and 1.9 in mCRC and 2.0 and 2.4 in NSCLC, respectively.
Conclusions : tdEVs have equivalent prognostic value as CTCs in the investigated metastatic cancers. CRPC, mCRC, and MBC (but not NSCLC) patients with favourable CTC counts can be further prognostically stratified using tdEVs. Our data suggest that tdEVs could be used in clinical decision-making.
British Journal of Cancer , article en libre accès, 2020