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Interpretation of changes in circulating tumor cell counts.

ABSTRACT: The presence of circulating tumor cells (CTCs) in the blood of cancer patients may guide the use of therapy. We investigated how to evaluate a reduction in the number of CTCs after administration of therapy. CTCs were enumerated with the CellSearch system in 111 metastatic breast and 185 metastatic prostate cancer patients before start of a new line of chemotherapy and after initiation of therapy. Different means to express changes in CTC counts were evaluated with respect to overall survival (OS). A static CTC cutoff is the best method to determine whether a therapy is effective. This is exemplified by the highest Cox hazard ratio of 2.1 for OS; three methods to express relative differences performed worse. A lookup table is provided from which the significance of a change in CTCs can be derived. The aim of therapy should be the elimination of all CTCs. A period of 10 to 12 weeks of therapy is needed to reach the treatment effect on CTCs.

SUBMITTER: Coumans FA

PROVIDER: S-EPMC3542841 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature

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Interpretation of changes in circulating tumor cell counts.

Coumans Frank Aw FA Ligthart Sjoerd T ST Terstappen Leon Wmm LW

Translational oncology 20121201 6

The presence of circulating tumor cells (CTCs) in the blood of cancer patients may guide the use of therapy. We investigated how to evaluate a reduction in the number of CTCs after administration of therapy. CTCs were enumerated with the CellSearch system in 111 metastatic breast and 185 metastatic prostate cancer patients before start of a new line of chemotherapy and after initiation of therapy. Different means to express changes in CTC counts were evaluated with respect to overall survival (O ...[more]

PMID: 23323160

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Project description:Population time series analysis is an integral part of conservation biology in the current context of global changes. To quantify changes in population size, wildlife counts only provide estimates because of various sources of error. When unaccounted for, such errors can obscure important ecological patterns and reduce confidence in the derived trend. In the case of highly gregarious species, which are common in the animal kingdom, the estimation of group size is an important potential bias, which is characterized by high variance among observers. In this context, it is crucial to quantify the impact of observer changes, inherent to population monitoring, on i) the minimum length of population time series required to detect significant trends and ii) the accuracy (bias and precision) of the trend estimate.We acquired group size estimation error data by an experimental protocol where 24 experienced observers conducted counting simulation tests on group sizes. We used this empirical data to simulate observations over 25 years of a declining population distributed over 100 sites. Five scenarios of changes in observer identity over time and sites were tested for each of three simulated trends (true population size evolving according to deterministic models parameterized with declines of 1.1%, 3.9% or 7.4% per year that justify respectively a "declining," "vulnerable" or "endangered" population under IUCN criteria).We found that under realistic field conditions observers detected the accurate value of the population trend in only 1.3% of the cases. Our results also show that trend estimates are similar if many observers are spatially distributed among the different sites, or if one single observer counts all sites. However, successive changes in observer identity over time lead to a clear decrease in the ability to reliably estimate a given population trend, and an increase in the number of years of monitoring required to adequately detect the trend.Minimizing temporal changes of observers improve the quality of count data and help taking appropriate management decisions and setting conservation priorities. The same occurs when increasing the number of observers spread over 100 sites. If the population surveyed is composed of few sites, then it is preferable to perform the survey by one observer. In this context, it is important to reconsider how we use estimated population trend values and potentially to scale our decisions according to the direction and duration of estimated trends, instead of setting too precise threshold values before action.

Dataset Information

Interpretation of changes in circulating tumor cell counts.

Publications

Interpretation of changes in circulating tumor cell counts.

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