Seoyoung Lee, Chaeyeon Kim, Chang Gon Kim, Min Hee Hong, Mina Han, Wonrak Son, Gamin Kim, Hyeong Jung Woo, Hyun Young Shin, Jungmin Lee, Minseok S Kim, Hye Ryun Kim
Received June 29, 2025 Accepted January 26, 2026 Published online January 27, 2026
Purpose
Circulating tumor cell (CTC) is a promising minimally invasive biomarker for EGFR-mutant non-small cell lung cancer (NSCLC). However, the rarity of CTCs and limitations in their isolation and molecular characterization hinder their clinical utility, particularly in predicting treatment outcomes. This study evaluates the potential of CTC molecular response to predict treatment efficacy and guide therapy in patients with EGFR-mutant NSCLC undergoing EGFR-tyrosine kinase inhibitors (TKI) therapy.
Materials and Methods
Seventy-seven patients with EGFR-mutant NSCLC treated with EGFR-TKIs were enrolled. CTCs were isolated using continuous centrifugal microfluidic technology (CCM-CTCD) and compared with ctDNA and tissue biopsy for EGFR mutation analysis. Patients were categorized as CTC molecular responders or non-responders based on a ≥ 44.4% reduction in CTC count from baseline. Progression-free survival (PFS) and tumor burden changes were evaluated.
Results
CTC responders had significantly longer PFS (46.3 vs. 13.6 months, p=0.007) and greater tumor burden reduction (-37.7% vs. -35.2%, p=0.218) compared to non-responders. The CCM-CTCD demonstrated concordance with the cobas test while exhibiting higher sensitivity for EGFR mutation detection among 46 patients who underwent both tests simultaneously. Mutational discordance among tissue, ctDNA, and CTCs highlighted tumor heterogeneity. CTC profiling complemented traditional methods for identifying genomic alterations and predicting early progression.
Conclusion
CTC analysis using CCM-CTCD shows potential as a biomarker for predicting treatment response and prognosis in EGFR-mutant NSCLC. Stratification by CTC molecular response may inform risk-adapted treatment; however, its clinical utility remains to be established. Prospective studies are warranted to validate these findings and determine the role of CTC-guided decision-making.
Purpose This study aimed to identify patients who would benefit from third and subsequent lines of chemotherapy in recurrent epithelial ovarian cancer (EOC).
Materials and Methods Recurrent EOC patients who received third, fourth, or fifth-line palliative chemotherapy were retrospectively analyzed. Patients’ survival outcomes were assessed according to chemotherapy lines. Based on the best objective response, patients were divided into good-response (stable disease or better) and poor response (progressive disease or those who died before response assessment) groups. Survival outcomes were compared between the two groups, and factors associated with chemotherapy responses were investigated.
Results A total of 189 patients were evaluated. Ninety-four and 95 patients were identified as good and poor response group respectively, during the study period of 2008 to 2021. The poor response group showed significantly worse progression-free survival (median, 2.1 months vs. 9.7 months; p < 0.001) and overall survival (median, 5.0 months vs. 22.9 months; p < 0.001) compared with the good response group. In multivariate analysis adjusting for clinicopathologic factors, short treatment-free interval (TFI) (hazard ratio [HR], 5.557; 95% confidence interval [CI], 2.403 to 12.850), platinum-resistant EOC (HR, 2.367; 95% CI, 1.017 to 5.510), and non-serous/endometrioid histologic type (HR, 5.045; 95% CI, 1.152 to 22.088) were identified as independent risk factors for poor response. There was no difference in serious adverse events between good and poor response groups (p=0.167).
Conclusion Third and subsequent lines of chemotherapy could be carefully considered for palliative purposes in recurrent EOC patients with serous or endometrioid histology, initial platinum sensitivity, and long TFIs from the previous chemotherapy regimen.
Citations
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CircSETDB1 contributes to paclitaxel resistance of ovarian cancer cells by sponging miR-508-3p and regulating ABCC1 expression Chunyan Huang, Li Qin, Sailan Chen, Qin Huang Anti-Cancer Drugs.2023; 34(3): 395. CrossRef
Se Ik Kim, Minsun Song, Suhyun Hwangbo, Sungyoung Lee, Untack Cho, Ju-Hyun Kim, Maria Lee, Hee Seung Kim, Hyun Hoon Chung, Dae-Shik Suh, Taesung Park, Yong-Sang Song
Cancer Res Treat. 2019;51(3):1144-1155. Published online November 20, 2018
Purpose
Discovery of models predicting the exact prognosis of epithelial ovarian cancer (EOC) is necessary as the first step of implementation of individualized treatment. This study aimed to develop nomograms predicting treatment response and prognosis in EOC.
Materials and Methods
We comprehensively reviewed medical records of 866 patients diagnosed with and treated for EOC at two tertiary institutional hospitals between 2007 and 2016. Patients’ clinico-pathologic characteristics, details of primary treatment, intra-operative surgical findings, and survival outcomes were collected. To construct predictive nomograms for platinum sensitivity, 3-year progression-free survival (PFS), and 5-year overall survival (OS), we performed stepwise variable selection by measuring the area under the receiver operating characteristic curve (AUC) with leave-one-out cross-validation. For model validation, 10-fold cross-validation was applied.
Results
The median length of observation was 42.4 months (interquartile range, 25.7 to 69.9 months), during which 441 patients (50.9%) experienced disease recurrence. The median value of PFS was 32.6 months and 3-year PFS rate was 47.8% while 5-year OS rate was 68.4%. The AUCs of the newly developed nomograms predicting platinum sensitivity, 3-year PFS, and 5-year OS were 0.758, 0.841, and 0.805, respectively. We also developed predictive nomograms confined to the patients who underwent primary debulking surgery. The AUCs for platinum sensitivity, 3-year PFS, and 5-year OS were 0.713, 0.839, and 0.803, respectively.
Conclusion
We successfully developed nomograms predicting treatment response and prognosis of patients with EOC. These nomograms are expected to be useful in clinical practice and designing clinical trials.
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Purpose This study was conducted to validate the prognostic influence of treatment response among patients with positive circumferential resection margin for locally advanced rectal cancer.
Materials and Methods Clinical data of 197 patientswith positive circumferentialresection margin defined as ≤ 2 mm after preoperative chemoradiotherapy followed by total mesorectal excision between 2004 and 2009were collected forthis multicenter validation study. All patients underwent median 50.4Gy radiationwith concurrentfluoropyrimidine based chemotherapy. Treatmentresponse was dichotomized to good response, including treatmentresponse of grade 2 or 3, and poor response, including grade 0 or 1.
Results After 52 months median follow-up, 5-year overall survival (OS) for good responders and poor responders was 79.1% and 48.4%, respectively (p < 0.001). In multivariate analysis, circumferential resection margin involvement and treatment response were a prognosticator for OS and locoregional recurrence-free survival. In subgroup analysis, good responders with close margin showed significantly better survival outcomes for survival. Good responders with involved margin and poor responders with close margin shared similar results, whereas poorresponderswith involved margin hadworst survival (5-year OS, 81.2%, 57.0%, 50.0%, and 32.4%, respectively; p < 0.001).
Conclusion Among patients with positive circumferential resection margin after preoperative chemoradiotherapy, survival of the good responders was significantly better than poor responders. Subgroup analysis revealed that definition of positive circumferential resection margin may be individualized as involvement for good responders, whereas ≤ 2 mm for poor responders.
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