Clinical significance of circulating tumor cells in colorectal cancer with peritoneal metastases - a prospective cohort study using a novel method for monitoring treatment response, and assessing minimal residual disease

Sep 21, 2026

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Study examines circulating tumor cells (CTCs) in colorectal cancer patients with peritoneal metastases and evaluates their value as a biomarker for disease progression, treatment response, and minimal residual disease using CellMate, a novel in vitro diagnostic platform. Forty-six patients were prospectively followed after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, with CTC presence measured the week of surgery. CTC detection correlated with significantly shorter recurrence-free and overall survival, especially when CTCs were present after neoadjuvant treatment.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages9

Reading Time23 min

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Background

Materials and methods

Results

Conclusions

’Tumour Marker Prognostic Study Clinical signiﬁcance of circulating tumor cells in colorectal cancer with peritoneal metastases: a prospective cohort study using a novel method for monitoring treatment response, and assessing minimal residual disease Petter Frühling, MD, PhDa,*, Louice Moberg, MDa , Lana Ghanipour, MD, PhDa , Helgi Birgisson, MD, PhDa , Wilhelm Graf, MD, PhDa , Christer Ericsson, PhDb , P. H. Cashin, MD, PhDa Background: The treatment for patients with colorectal cancer with metastases to the peritoneum is complex and may involve both surgery and chemotherapy. Circulating tumor cells (CTCs) have been poorly investigated in peritoneal metastatic colorectal cancer. The aim of the study is to examine the role of CTCs as a biomarker for monitoring disease progression, treatment response, and residual disease using CellMate – a new promising in vitro diagnostic platform technology. Materials and methods: The authors prospectively followed the clinical outcomes of 46 patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with peritoneal metastases and examined whether CTCs were present the week of surgery. The CTC measurements were made with the CellMate technology, which is a platform technology to detect CTCs based on the difference in biomechanical properties compared to blood resident cells. The study was registered online ([ClinicalTrials.gov](ClinicalTrials.gov)) . Results: CTCs were detected in 17 (37%) patients. The presence of CTCs was associated with shorter recurrence-free survival and overall survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Both recurrence-free survival (HR 4 .00, 95% CI: 1 .15–13.9; P = 0.029) and overall survival (HR 5 .91; 95% CI: 1 .18–29.7; P = 0.03) were signiﬁcantly worse if CTCs were detected after neoadjuvant treatment. In the subgroup of patients with CTCs detected, adjuvant therapy tended to improve the prognosis while in CTC negative patients it did not. Conclusions: Pending a prospective multicenter trial to validate these ﬁndings, CTCs may in the future be used as a dynamic personalized biomarker for prognostication, predicting response to therapy, and for monitoring disease progression in colorectal cancer with metastases to the peritoneum. Keywords: circulating tumor cells, colorectal cancer, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, oxaliplatin, peritoneal metastases Introduction Colorectal cancer is the second leading cause of cancer-related death in the world[1,2] . About 90% of cancer-related death is attributed to metastasis[3,4] . Approximately 15–25% of all patients with colorectal cancer have distant metastases at the time of diagnosis. After the liver, the most common sites of metastases are the lungs, intra-abdominal lymph nodes, and the peritoneum[5] . In the past, patients with peritoneal metastases were offered palliative care only. Following the introduction of cytoreductive surgery (CRS)[6] and hyperthermic intraperitoneal chemotherapy (HIPEC)[7]; a selected group of patients may be aDepartment of Surgical Sciences, Section of Surgery, Uppsala University, Akademiska Sjukhuset, Uppsala and biCellate Medical AB, KI Science Park, Industrivägen 1, Sweden Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. *Corresponding author. Address: Department of Surgical Sciences, Uppsala University Hospital, Uppsala Sweden. Tel.: +46 (0) [18 611 00 00. E-mail: petter.fruhling@uu.se](18 611 00 00. E-mail: petter.fruhling@uu.se) (P. Frühling). Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed i

FAQs

What is the study aimed to determine about CTCs in colorectal cancer with peritoneal metastases?

The study assesses whether circulating tumor cells can serve as a biomarker for monitoring disease progression, treatment response, and minimal residual disease.

How were patients and CTCs evaluated in the prospective cohort study?

Forty-six patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were prospectively followed, and CTCs were measured the week of surgery using the CellMate technology.

What outcomes were associated with CTC detection?

CTCs were detected in 17 patients and were associated with shorter recurrence-free survival and overall survival after treatment, with worse outcomes when CTCs were detected after neoadjuvant therapy.

Sep 21, 2026

Uploaded by Quinn