No Association Between Circulating Tumor Cells and Locally Advanced and Metastatic SCC of the Head and Neck Prognosis

Are circulating tumor cells (CTCs) associated with prognosis in patients with locally advanced and metastatic squamous cell carcinoma of the head and neck (SCCHN)?

BOTTOM LINE: Circulating tumor cells are not associated with prognosis in patients with locally advanced and metastatic SCCHN, but CTCs are present.

BACKGROUND: CTCs are considered an early step toward metastasis and have been linked to poor prognosis in several types of cancer, including breast, lung, and ovarian cancer. However, the role of CTCs in SCCHN remains unclear.

STUDY DESIGN: Individual prospective cohort study.

SETTING: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston.

SYNOPSIS: Researchers looked at 47 patients (44 men, 3 women, median age 55.5 years) with pathologically confirmed SCCHN and locoregionally advanced or distant metastatic disease to ascertain the effect of CTCs on patient progression-free survival (PFS) and overall survival (OS). Prior to the study, patients had been assigned treatment by their oncologists to one of three regimens: sequential induction followed by chemoradiotherapy (CRT), concurrent CRT, or systemic treatment for distant metastatic disease. Of the 36 patients who had a successful CTC assessment prior to treatment, 25 had locally advanced disease and 11 had metastatic disease. Baseline CTCs in varying amounts were detected in 10 patients. Of these, nine had a significant smoking history, indicating a positive association on univariate analysis, contrary to the findings of previous studies. Researchers did not find an association between CTCs and PFS or OS, although studies of other cancers have suggested otherwise. It was suggested that the CellSearch CTC detection method might not be adequate in selecting the most prognostic population among patients with SCCHN. Study limitations include low enrollment and lack of treatment standardization within cohorts.

CITATION: Harris EJ, Huang J, Carroll E, et al. Circulating tumor cell analysis in locally advanced and metastatic squamous cell carcinoma of the head and neck [published online ahead of print October 27, 2020]. Laryngoscope Investig Otolaryngol. doi: 10.1002/lio2.448.