Macrovascular tumor infiltration and circulating tumor cell cluster dynamics in patients with cancer approaching the end of life
OPEN ACCESS
Loading...
Author / Producer
Date
2025-12
Publication Type
Journal Article
ETH Bibliography
yes
OPEN ACCESS
Data
Abstract
End-of-life events related to carcinoma lethality are poorly characterized. Herein we conducted an observational, prospective, case–control study enrolling 21 patients with solid tumors and 10 patients without known malignancy, complemented by a retrospective validation cohort of 1,250 patients with cancer. In our prospective cohort, we observed spikes in circulating tumor cell (CTC) counts, particularly clusters, immediately before death (P < 0.0001), as well as pathological evidence of macrovascular infiltration and large-vessel occlusion obtained through rapid autopsy. In the validation cohort, radiological evidence of macrovascular infiltration emerged as the strongest predictor of poor survival—independent of metastasis—in treatment-homogeneous patients with colorectal, lung, ovarian, hepatocellular or pancreatic cancer (hazard ratios = 4.0–22.4). Collectively, these findings suggest that macrovascular infiltration and spikes in CTC clusters with consequent vascular failure could be pivotal end-of-life events associated with cancer lethality, providing a rationale for future trials aimed at curbing infiltration into large vessels.
Permanent link
Publication status
published
External links
Editor
Book title
Journal / series
Volume
31 (12)
Pages / Article No.
4140 - 4149
Publisher
Nature
Event
Edition / version
Methods
Software
Geographic location
Date collected
Date created
Subject
Cancer
Organisational unit
09736 - Aceto, Nicola / Aceto, Nicola
Notes
Funding
101001652 - Tumor-lock: forbid the generation of circulating tumor cells (EC)
212183 - CRISPR screen for immunotherapy sensitizers in humanized circulating tumor cell xenografts (SNF)
212183 - CRISPR screen for immunotherapy sensitizers in humanized circulating tumor cell xenografts (SNF)