Circulating tumour cells a promising prognostic in neuroendocrine cancer

A study conducted at the UCL Cancer Institute has found that the presence of cancer cells circulating in the blood could predict the outcome or prognosis of neuroendocrine cancer.

Currently, tumor grade provides the best method of defining prognosis in this tumour type, but this is usually based on a small biopsy sample taken at diagnosis that may not reflect the tumour evolution or heterogeneity present in advanced tumors.

Neuroendocrine tumours often grow slowly, and it may be several years before symptoms appear and the tumour is diagnosed. However, some are fast-growing and more likely to spread to other parts of the body.

The research, published in the Journal of Clinical Oncology, looked at the number of circulating tumour cells in blood samples of 176 patients with metastatic (a spread of) neuroendocrine tumours. CTCs are cells that have shed into the blood vessels from a primary tumour and circulate in the bloodstream.

The study found that 49% of patients had at least one CTC, 42% had two or more CTCs, and 30% had five or more CTCs in 7.5 mL blood. A higher number of CTCs was associated with more rapid tumour growth and reduced survival.

CTC measurements are now being incorporated into trials of new therapies for neuroendocrine cancer.  Additional studies are under way to characterise CTCs in terms of their mutational and gene expression profile and this may help to select the best treatment for individual patients in the future.

The study was led by Dr Tim Meyer and supported by University College London (UCL) Experimental CancerMedicine Centre, the IPSEN Fund Clinical Research Fellowship (M.S.K.), the National Institute for Health Research University College London Hospitals Biomedical Research Centre, and the Bottoms Up Charity.