WCLC 2025 - Posters & ePosters-EP.06.74 Clinical Validity of Repeated CTCs and CAM-L Enumeration in Treatment Monitoring of Metastatic Non-Small Cell Lung Cancer

EP.06.74 Clinical Validity of Repeated CTCs and CAM-L Enumeration in Treatment Monitoring of Metastatic Non-Small Cell Lung Cancer

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This study investigated the clinical validity of serial measurements of circulating tumor cells (CTCs) and cancer-associated macrophage-like cells (CAM-Ls) for monitoring treatment in metastatic non-small cell lung cancer (mNSCLC). While targeted therapies and immune checkpoint inhibitors (ICIs) have improved mNSCLC survival, reliable biomarkers for prognosis remain limited. CTCs are known to correlate with poor overall survival (OS), and CAM-Ls—macrophages that have internalized dying tumor cells—are emerging as potential biomarkers, but their combined prognostic value has not been previously explored.<br /><br />Researchers analyzed CTC and CAM-L levels using the CellSearch platform at baseline (T0) and after three months (T1) in 77 mNSCLC patients undergoing first-line treatments: ICIs (39%), targeted therapies (22%), or chemotherapy (39%). Patients were categorized based on CTC presence at both timepoints: negative/negative (neg/neg), negative/positive (neg/pos), positive/negative (pos/neg), and positive/positive (pos/pos). Median OS was longest in neg/pos (33 months) and neg/neg (26 months) groups and shortest in pos/pos and pos/neg groups (10 months each), with similar trends in progression-free survival (PFS).<br /><br />Notably, patients with persistent CTC positivity (pos/pos) had significantly shorter PFS and OS compared to those who cleared CTCs (pos/neg). Moreover, T1-CTC negativity and T1-CAM-L positivity independently predicted better survival outcomes, regardless of PD-L1 status, treatment type, metastasis count, and age. CAM-L positivity was more common in patients treated with ICIs (Odds Ratio 3.53). These findings suggest that combined serial monitoring of CTCs and CAM-Ls could serve as robust independent prognostic biomarkers in mNSCLC, supporting further clinical trials to validate their clinical utility in guiding treatment decisions.

Asset Subtitle

Marco Siringo

Meta Tag

Speaker Marco Siringo

Topic Pathology and Biomarkers

Keywords

circulating tumor cells

CTCs

cancer-associated macrophage-like cells

CAM-Ls

metastatic non-small cell lung cancer

mNSCLC

immune checkpoint inhibitors

ICIs

overall survival

progression-free survival