Circulating tumor cells as prognostic biomarkers in advanced gastric cancer treated with CDC25B phosphatase inhibitors

Targeted therapies, such as the CDC25B inhibitor menadione, have shown promise in treating gastric cancer (GC). Circulating tumor cells (CTCs) are emerging as a tool for monitoring treatment efficacy. This study aims to assess the impact of CTC counts on treatment outcomes and the efficacy of menadione in GC. This analysis of a phase II randomized trial included patients with gastric adenocarcinoma treated with Menadione plus XELOX or XELOX alone. Kaplan-Meier curves were used to analyze overall survival (OS) and progression-free survival (PFS), comparing CTC responders (CTC resp) and non-responders (No CTC resp). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated, and p-values < 0.05 were considered significant. Of the 107 patients, 54 received Menadione + XELOX and 53 received XELOX alone. In the Menadione group, CTC responders had better OS, with HRs of 1.65 at 3 months, 7.47 at 6 months, and 1.90 at 15 months (p < 0.001). PFS analysis showed a higher risk of progression in No-CTC responders, with HRs of 2.28 at 3 months and 10.5 at 15 months (p < 0.001). Patients without CTC response had worse OS and PFS in both treatment groups, suggesting that CTC response could be a valuable predictor of clinical outcomes, warranting more intensive monitoring and tailored therapies for specific subgroups.