GU Cancers 2019 | CTCs in metastatic GU cancer: association with clinical outcomes?

Andrea Apolo

Andrea Apolo, MD, of the National Cancer Institute, Bethesda, MD, speaks at the 2019 Genitourinary Cancers Symposium, held in San Francisco, CA. She discusses her group’s investigation of circulating tumor cells (CTCs) in patients with metastatic genitourinary tumors treated in a Phase I study of cabozantinib and nivolumab +/- ipilimumab. This included the association between baseline CTC enumeration, change in CTC enumeration post-treatment, PFS, OS and response to treatment.

Transcript (edited for clarity):

Another abstract that we have here is on circulating tumor cells. We took patients with bladder cancer and other GU malignancies that are in our trial with cabozantinibnivolumab or cabozantinibnivolumabipilimumab and we looked at the circulating tumor cells at baseline at cycle 2, day one and at cycle 3, day one. We found that about 75% of the sample, so, there’s 52 patients, 128 samples, about 75% of the samples had CTCs. The majority of the patients were bladder cancer, but it also included patients that had rare bladder histology or other GU tumor types.

What we’ve found that was interesting was that if you had CTCs at baseline and they didn’t go down at cycle 2, day one, that was prognostic. The patients did worse. Another finding was that the CTCs have their own morphology. They have either a lot of cytoplasm, big nucleus, elongated nucleus, and that actually made a difference in terms of outcomes. These CTCs can be categorized by their morphology. We used the Epic platform, and depending on their morphology, there was different prognosis.

So what we hope to do now is look at the CTCs, look at the genomics of the CTCs and see, understand a little bit more about the prognostic value of the genomics in these CTCs within this patient population.

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