# Circulating tumour cell gene expression and chemosensitivity analyses: predictive accuracy for response to multidisciplinary treatment of patients with unresectable refractory recurrent rectal cancer or unresectable refractory colorectal cancer liver metastases

Source: https://onco.cc/key-papers/paper-guadagni-rgcc-ctc-colorectal-bmc-cancer-2022/  
OnCo record `paper-guadagni-rgcc-ctc-colorectal-bmc-cancer-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In 36 selected people with heavily treated colorectal cancer, a circulating tumour cell workflow predicted response with 47.2% overall accuracy and 5.3% specificity. There was no randomised comparison, and the assay was only one part of a complex treatment programme.

## Summary

This retrospective study selected 36 people with unresectable refractory recurrent rectal cancer or colorectal cancer liver metastases. Drugs for intra-arterial chemotherapy and targeted treatment were chosen using chemosensitivity and gene-expression analyses of cultured circulating tumour cells.

The combined workflow reported 94.1% sensitivity, 5.3% specificity, 47.1% positive predictive value, 50% negative predictive value and 47.2% overall predictive accuracy. The study had no untreated or standard-care comparison group, and the specialised locoregional treatment makes it impossible to isolate the contribution of the assay. RGCC personnel performed the assays and were among the authors.

## Fields

- Kind: Key paper
- Last checked: 2026-11-04
- Tags: rgcc; retrospective; evidence:limited
- Journal: BMC Cancer
- Year: 2022
- DOI: 10.1186/s12885-022-09770-3
- Authors: Guadagni S, Masedu F, Fiorentini G, et al.
- Findings: The reported overall predictive accuracy was 47.2%, with a 95% confidence interval of 30% to 64%.; Reported sensitivity was 94.1%, specificity 5.3%, positive predictive value 47.1% and negative predictive value 50%.; All 36 participants received a multidisciplinary treatment programme; the study did not compare assay-guided care with a randomised standard-care group.
- What it means: The study shows that the workflow was technically feasible, but its low specificity and uncontrolled design do not establish reliable treatment prediction or patient benefit.
- Caveats: Small retrospective selected cohort with no randomised or contemporary control group.; The assay's effect cannot be separated from intra-arterial chemotherapy, targeted treatment and other parts of the programme.; Cut-offs were evaluated in the same small dataset, and culturing circulating tumour cells may alter their characteristics.; RGCC personnel were coauthors and performed the assay work.

## Sources

- PubMed Central full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC9202660/
- PubMed: https://pubmed.ncbi.nlm.nih.gov/35710393/
- Publisher article: https://doi.org/10.1186/s12885-022-09770-3

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/)
- technologies: [Circulating tumour cell capture](https://onco.cc/technologies/ctc-capture/), [Functional (ex vivo) drug testing](https://onco.cc/technologies/functional-drug-testing/), [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/)
- companies: [RGCC International](https://onco.cc/companies/rgcc-international/)

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