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document
Monitoring tumour cells in the peripheral blood of small cell lung cancer patients . BACKGROUND Flow cytometry was used to enumerate tumour cells in longitudinal studies of peripheral blood from small cell lung cancer ( SCLC ) patients , together with magnetic bead selection to isolate and identify these cells . As part of a trial , 11 patients received either standard ( four weekly ) chemotherapy with ifosfamide , carboplatin , and etoposide ( ICE ) or accelerated ( two weekly ) ICE with filgrastim ( granulocyte colony-stimulating factor [ G-CSF ] ) and autologous stem cell support . METHODS Fresh venous blood was taken throughout treatment and follow-up . Aliquots were stained with a " tumour-specific " antibody against epithelial tissue ( Ber EP4 ) , verified as a good marker of SCLC cells by immunohistochemistry . Matched samples labelled with Ber EP4 were separated magnetically by adding a secondary bead-antibody conjugate for confirmation of tumour cell identity . RESULTS Circulating tumour cells were detected and monitored throughout treatment periods . An initial rise in circulating cells after the first cycle was followed by a fall in both treatment arms to baseline levels set by normal controls . This was achieved by week 12 in the accelerated treatment arm and by week 24 in the standard arm . CONCLUSIONS Flow cytometry and magnetic bead isolation can be used to identify changes in numbers of circulating tumour cells in patients undergoing chemotherapy for SCLC and thereafter during follow-up periods . Absence of tumour cells may indicate a more favourable patient group who would benefit from a more intense course of treatment .
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Intervention_Other
Flow cytometry
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Intervention_Pharmacological
chemotherapy
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Intervention_Pharmacological
ifosfamide
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Intervention_Pharmacological
carboplatin
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Intervention_Pharmacological
etoposide ( ICE )
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Intervention_Pharmacological
accelerated ( two weekly ) ICE with filgrastim
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Intervention_Pharmacological
granulocyte colony-stimulating factor [ G-CSF ]
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Intervention_Pharmacological
autologous stem cell support
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Intervention_Pharmacological
chemotherapy
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Outcome_Physical
Circulating tumour cells
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Outcome_Physical
initial rise in circulating cells after the first cycle