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Circulating Tumor Cells

 

Circulating Tumor Cells and the “Liquid Biopsy”

Metastatic cancer is still often considered a fatal disease. The breaking away of cells from the primary solid tumor and their spread to other parts of the body via the bloodstream often correlates with poor prognosis. Such circulating tumor cells (CTCs) have been detected in the peripheral blood of cancer patients as early as 1869 and have now been observed for many various types of metastatic disease.  It is now clear that CTCs have the potential to become a surrogate of tumor biopsy and could enable determination of optimized (personalized) treatment benefit based on the biology of individual tumors. 

As result, methods for noninvasive recovery of CTCs from cancer patient's blood and the application of tumor biomarkers to better elucidate molecular pathways for therapy selection have been the focus of numerous studies and clinical trials.

 

CTCs are Rare and Heterogeneous

Despite the obvious importance of CTCs, incorporation into standard screening and treatment guidelines has been challenging due to a number of factors. Firstly, CTCs are extremely rare in comparison to hematologic cells (about 1 tumor cell per 1 billion blood cells), which make them difficult to isolate. Second, though many strategies have been developed to allow recovery of CTCs for enumeration, few enable subsequent molecular analysis of pure CTCs.  Moreover, heterogeneity among CTCs can exist, making downstream analysis unreliable when pooling cells following recovery from blood.  

 

The Value of CTCs enumeration with CellSearch

The CellSearch® System is an advanced technology for detection of circulating tumor cell  from blood using proprietary immunomagnetic technology.

A positive correlation between the frequency of CELLSEARCH® CTCs and patient survival has been demonstrated for metastatic breast cancer (Cristofanilli et al., 2014 Breast Cancer), metastatic prostate cancer (deBono et al., 2014 Am Soc Clin Oncol Educ Book), and metastatic colorectal cancer.  The detection and enumeration of CTCs with CellSearch by means of antibody-based capture followed by differential fluorescent staining to distinguish CTCs from normal cells has been shown to be a prognostic indicator of patient risk in metastatic breast, prostate and colorectal cancer (for full intended use and information visit http://www.cellsearchctc.com/).

Efforts to go beyond enumeration of CTCs to include the molecular characterization could provide important additional information and improve the clinical utility of CTCs.

 

The most comprehensive solution for cell-based liquid biopsy

CELLSEARCH and DEPArray together provide an end-to-end workflow solution* in cell-based liquid biopsy to study circulating tumor cells in the clinical research setting.

 

 

The DEPArray platform bridges the gap between CellSearch enrichment and what is needed for downstream molecular applications to effectively characterize tumor cells from peripheral blood. The ability to sort and recover individual cells, or pools of common phenotypes, overcomes the limitations associated with analysis of enriched samples that are compromised by the presence of normal peripheral blood cells intermixed with heterogeneous tumor (CTC) cells. 

When combined with single cell whole genome amplification (see Ampli1 WGA Kit) more sensitive and reliable profiling of tumor cell populations recovered from a simple blood draw can be achieved. 

Ampli1 LowPass Kit and Ampli1 OncoSeek Panel- will drive you through the processing of CTC DNA for mutation detection and Copy Number Aberration by NGS analysis.

*For Research use Only. Not for Use in Diagnostic Procedures.

 


To review publications and resource references, please visit our Publications page.