351
|
Somarelli JA, Ware KE, Kostadinov R, Robinson JM, Amri H, Abu-Asab M, Fourie N, Diogo R, Swofford D, Townsend JP. PhyloOncology: Understanding cancer through phylogenetic analysis. Biochim Biophys Acta Rev Cancer 2016; 1867:101-108. [PMID: 27810337 DOI: 10.1016/j.bbcan.2016.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/14/2016] [Accepted: 10/26/2016] [Indexed: 11/30/2022]
Abstract
Despite decades of research and an enormity of resultant data, cancer remains a significant public health problem. New tools and fresh perspectives are needed to obtain fundamental insights, to develop better prognostic and predictive tools, and to identify improved therapeutic interventions. With increasingly common genome-scale data, one suite of algorithms and concepts with potential to shed light on cancer biology is phylogenetics, a scientific discipline used in diverse fields. From grouping subsets of cancer samples to tracing subclonal evolution during cancer progression and metastasis, the use of phylogenetics is a powerful systems biology approach. Well-developed phylogenetic applications provide fast, robust approaches to analyze high-dimensional, heterogeneous cancer data sets. This article is part of a Special Issue entitled: Evolutionary principles - heterogeneity in cancer?, edited by Dr. Robert A. Gatenby.
Collapse
Affiliation(s)
- Jason A Somarelli
- Duke Cancer Institute and the Department of Medicine, Duke University Medical Center, Durham, NC 27710, United States.
| | - Kathryn E Ware
- Duke Cancer Institute and the Department of Medicine, Duke University Medical Center, Durham, NC 27710, United States
| | - Rumen Kostadinov
- Pediatric Oncology, School of Medicine, Johns Hopkins University, United States
| | - Jeffrey M Robinson
- Anatomy Department, College of Medicine, Howard University, Washington, DC 20059, United States; Digestive Disorders Unit, National Institute of Nursing Research, NIH, Bethesda, MD 20892, United States
| | - Hakima Amri
- Department of Biochemistry and Cellular and Molecular Biology, Georgetown University Medical Center, Washington, DC 20007, United States
| | - Mones Abu-Asab
- Section of Ultrastructural Biology, National Eye Institute, NIH, Bethesda, MD 20892, United States
| | - Nicolaas Fourie
- Digestive Disorders Unit, National Institute of Nursing Research, NIH, Bethesda, MD 20892, United States
| | - Rui Diogo
- Anatomy Department, College of Medicine, Howard University, Washington, DC 20059, United States
| | - David Swofford
- Department of Biology, Duke University Trinity College of Arts and Sciences, Durham, NC 27710, United States
| | - Jeffrey P Townsend
- Department of Biostatistics, Yale University, United States; Department of Ecology and Evolutionary Biology, Yale University, United States; Department of Program in Computational Biology and Bioinformatics, Yale University, United States.
| |
Collapse
|
352
|
Bulfoni M, Turetta M, Del Ben F, Di Loreto C, Beltrami AP, Cesselli D. Dissecting the Heterogeneity of Circulating Tumor Cells in Metastatic Breast Cancer: Going Far Beyond the Needle in the Haystack. Int J Mol Sci 2016; 17:ijms17101775. [PMID: 27783057 PMCID: PMC5085799 DOI: 10.3390/ijms17101775] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 10/08/2016] [Accepted: 10/17/2016] [Indexed: 02/06/2023] Open
Abstract
Although the enumeration of circulating tumor cells (CTC) defined as expressing both epithelial cell adhesion molecule and cytokeratins (EpCAM+/CK+) can predict prognosis and response to therapy in metastatic breast, colon and prostate cancer, its clinical utility (i.e., the ability to improve patient outcome by guiding therapy) has not yet been proven in clinical trials. Therefore, scientists are now focusing on the molecular characterization of CTC as a way to explore its possible use as a “surrogate” of tumor tissues to non-invasively assess the genomic landscape of the cancer and its evolution during treatment. Additionally, evidences confirm the existence of CTC in epithelial-to-mesenchymal transition (EMT) characterized by a variable loss of epithelial markers. Since the EMT process can originate cells with enhanced invasiveness, stemness and drug-resistance, the enumeration and characterization of this population, perhaps the one truly responsible of tumor recurrence and progression, could be more clinically useful. For these reasons, several devices able to capture CTC independently from the expression of epithelial markers have been developed. In this review, we will describe the types of heterogeneity so far identified and the key role played by the epithelial-to-mesenchymal transition in driving CTC heterogeneity. The clinical relevance of detecting CTC-heterogeneity will be discussed as well.
Collapse
Affiliation(s)
- Michela Bulfoni
- Department of Medical and Biological Sciences, University of Udine, Piazzale M. Kolbe 4, 33100 Udine, Italy.
| | - Matteo Turetta
- Department of Medical and Biological Sciences, University of Udine, Piazzale M. Kolbe 4, 33100 Udine, Italy.
| | - Fabio Del Ben
- Department of Clinical Pathology, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081 Aviano, Italy.
| | - Carla Di Loreto
- Department of Medical and Biological Sciences, University of Udine, Piazzale M. Kolbe 4, 33100 Udine, Italy.
- Institute of Pathology, University Hospital of Udine-ASUIUD, Piazzale Santa Maria della Misericordia 15, 33100 Udine, Italy.
| | - Antonio Paolo Beltrami
- Department of Medical and Biological Sciences, University of Udine, Piazzale M. Kolbe 4, 33100 Udine, Italy.
| | - Daniela Cesselli
- Department of Medical and Biological Sciences, University of Udine, Piazzale M. Kolbe 4, 33100 Udine, Italy.
| |
Collapse
|
353
|
Schoser B. Diagnostic muscle biopsy: is it still needed on the way to a liquid muscle pathology? Curr Opin Neurol 2016; 29:602-5. [DOI: 10.1097/wco.0000000000000366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
354
|
Pathologists and liquid biopsies: to be or not to be? Virchows Arch 2016; 469:601-609. [PMID: 27553354 DOI: 10.1007/s00428-016-2004-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 06/25/2016] [Accepted: 08/09/2016] [Indexed: 12/19/2022]
Abstract
Recently, the advent of therapies targeting genomic alterations has improved the care of patients with certain types of cancer. While molecular targets were initially detected in nucleic acid samples extracted from tumor tissue, detection of nucleic acids in circulating blood has allowed the development of what has become known as liquid biopsies, which provide a complementary and alternative sample source allowing identification of genomic alterations that might be addressed by targeted therapy. Consequently, liquid biopsies might rapidly revolutionize oncology practice in allowing administration of more effective treatments. Liquid biopsies also provide an approach towards short-term monitoring of metastatic cancer patients to evaluate efficacy of treatment and/or early detection of secondary mutations responsible for resistance to treatment. In this context, pathologists, who have already been required in recent years to take interest in the domain of molecular pathology of cancer, now face new challenges. The attitude of pathologists to and level of involvement in the practice of liquid biopsies, including mastering the methods employed in molecular analysis of blood samples, need close attention. Regardless of the level of involvement of pathologists in this new field, it is mandatory that oncologists, biologists, geneticists, and pathologists work together to coordinate the pre-analytical, analytical, and post-analytical phases of molecular assessment of tissue and liquid samples of individual cancer patients. The challenges include (1) implementation of effective and efficient procedures for reception and analysis of liquid and tissue samples for histopathological and molecular evaluation and (2) assuring short turn-around times to facilitate rapid optimization of individual patient treatment. In this paper, we will review the following: (1) recent data concerning the concept of liquid biopsies in oncology and its development for patient care, (2) advantages and limitations of molecular analyses performed on blood samples compared to those performed on tissue samples, and (3) short-term challenges facing pathologists in dealing with liquid biopsies of cancer patients and new strategies to early detect metastatic tumor cell clones.
Collapse
|
355
|
Sawada T, Araki J, Yamashita T, Masubuchi M, Chiyoda T, Yunokawa M, Hoshi K, Tao S, Yamamura S, Yatsushiro S, Abe K, Kataoka M, Shimoyama T, Maeda Y, Kuroi K, Tamura K, Sawazumi T, Minami H, Suda Y, Koizumi F. Prognostic Impact of Circulating Tumor Cell Detected Using a Novel Fluidic Cell Microarray Chip System in Patients with Breast Cancer. EBioMedicine 2016; 11:173-182. [PMID: 27495793 PMCID: PMC5049925 DOI: 10.1016/j.ebiom.2016.07.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/30/2016] [Accepted: 07/22/2016] [Indexed: 12/13/2022] Open
Abstract
Various types of circulating tumor cell (CTC) detection systems have recently been developed that show a high CTC detection rate. However, it is a big challenge to find a system that can provide better prognostic value than CellSearch in head-to-head comparison. We have developed a novel semi-automated CTC enumeration system (fluidic cell microarray chip system, FCMC) that captures CTC independently of tumor-specific markers or physical properties. Here, we compared the CTC detection sensitivity and the prognostic value of FCMC with CellSearch in breast cancer patients. FCMC was validated in preclinical studies using spike-in samples and in blood samples from 20 healthy donors and 22 breast cancer patients in this study. Using spike-in samples, a statistically higher detection rate (p = 0.010) of MDA-MB-231 cells and an equivalent detection rate (p = 0.497) of MCF-7 cells were obtained with FCMC in comparison with CellSearch. The number of CTC detected in samples from patients that was above a threshold value as determined from healthy donors was evaluated. The CTC number detected using FCMC was significantly higher than that using CellSearch (p = 0.00037). CTC numbers obtained using either FCMC or CellSearch had prognostic value, as assessed by progression free survival. The hazard ratio between CTC + and CTC − was 4.229 in CellSearch (95% CI, 1.31 to 13.66; p = 0.01591); in contrast, it was 11.31 in FCMC (95% CI, 2.245 to 57.0; p = 0.000244). CTC detected using FCMC, like the CTC detected using CellSearch, have the potential to be a strong prognostic factor for cancer patients.
Collapse
Affiliation(s)
- Takeshi Sawada
- Department of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan; Department of Medical Oncology/Hematology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Jungo Araki
- Konica Minolta, Inc., 1 Sakuramachi, Hino, Tokyo 191-8511, Japan
| | - Toshinari Yamashita
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
| | - Manami Masubuchi
- Konica Minolta, Inc., 1 Sakuramachi, Hino, Tokyo 191-8511, Japan
| | - Tsuneko Chiyoda
- Konica Minolta, Inc., 1 Sakuramachi, Hino, Tokyo 191-8511, Japan
| | - Mayu Yunokawa
- Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Kumiko Hoshi
- Konica Minolta, Inc., 1 Sakuramachi, Hino, Tokyo 191-8511, Japan
| | - Shoichi Tao
- Konica Minolta, Inc., 1 Sakuramachi, Hino, Tokyo 191-8511, Japan
| | - Shohei Yamamura
- Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 2217-14 Hayashi-cho, Takamatsu, Kagawa 761-0395, Japan
| | - Shouki Yatsushiro
- Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 2217-14 Hayashi-cho, Takamatsu, Kagawa 761-0395, Japan
| | - Kaori Abe
- Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 2217-14 Hayashi-cho, Takamatsu, Kagawa 761-0395, Japan
| | - Masatoshi Kataoka
- Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 2217-14 Hayashi-cho, Takamatsu, Kagawa 761-0395, Japan
| | - Tatsu Shimoyama
- Department of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
| | - Yoshiharu Maeda
- Department of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
| | - Katsumasa Kuroi
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
| | - Kenji Tamura
- Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Tsuneo Sawazumi
- Konica Minolta, Inc., 1 Sakuramachi, Hino, Tokyo 191-8511, Japan
| | - Hironobu Minami
- Department of Medical Oncology/Hematology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Yoshihiko Suda
- Konica Minolta, Inc., 1 Sakuramachi, Hino, Tokyo 191-8511, Japan
| | - Fumiaki Koizumi
- Division of Clinical Research Support, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
| |
Collapse
|
356
|
Hamilton G, Rath B. Detection of circulating tumor cells in non-small cell lung cancer. J Thorac Dis 2016; 8:1024-8. [PMID: 27293809 DOI: 10.21037/jtd.2016.03.86] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Gerhard Hamilton
- Society for Research on Biology and Therapy of Cancer, A-1160 Vienna, Austria
| | - Barbara Rath
- Society for Research on Biology and Therapy of Cancer, A-1160 Vienna, Austria
| |
Collapse
|
357
|
Adams DL, Adams DK, Stefansson S, Haudenschild C, Martin SS, Charpentier M, Chumsri S, Cristofanilli M, Tang CM, Alpaugh RK. Mitosis in circulating tumor cells stratifies highly aggressive breast carcinomas. Breast Cancer Res 2016; 18:44. [PMID: 27142282 PMCID: PMC4855427 DOI: 10.1186/s13058-016-0706-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 04/19/2016] [Indexed: 12/14/2022] Open
Abstract
Background Enumeration of circulating tumor cells (CTCs) isolated from the peripheral blood of breast cancer patients holds promise as a clinically relevant, minimally invasive diagnostic test. However, CTC utility has been limited as a prognostic indicator of survival by the inability to stratify patients beyond general enumeration. In comparison, histological biopsy examinations remain the standard method for confirming malignancy and grading malignant cells, allowing for cancer identification and then assessing patient cohorts for prognostic and predictive value. Typically, CTC identification relies on immunofluorescent staining assessed as absent/present, which is somewhat subjective and limited in its ability to characterize these cells. In contrast, the physical features used in histological cytology comprise the gold standard method used to identify and preliminarily characterize the cancer cells. Here, we superimpose the methods, cytologically subtyping CTCs labeled with immunohistochemical fluorescence stains to improve their prognostic value in relation to survival. Methods In this single-blind prospective pilot study, we tracked 36 patients with late-stage breast cancer over 24 months to compare overall survival between simple CTC enumeration and subtyping mitotic CTCs. A power analysis (1-β = 0. 9, α = 0.05) determined that a pilot size of 30 patients was sufficient to stratify this patient cohort; 36 in total were enrolled. Results Our results confirmed that CTC number is a prognostic indicator of patient survival, with a hazard ratio 5.2, p = 0.005 (95 % CI 1.6–16.5). However, by simply subtyping the same population based on CTCs in cytological mitosis, the hazard ratio increased dramatically to 11.1, p < 0.001 (95 % CI 3.1–39.7). Conclusions Our data suggest that (1) mitotic CTCs are relativity common in aggressive late-stage breast cancer, (2) mitotic CTCs may significantly correlate with shortened overall survival, and (3) larger and more defined patient cohort studies are clearly called for based on this initial pilot study. Electronic supplementary material The online version of this article (doi:10.1186/s13058-016-0706-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Daniel L Adams
- Creatv MicroTech, Inc., 11 Deer Park Dr., Monmouth Junction, NJ, 08852, USA.
| | - Diane K Adams
- Rutgers, the State University of New Jersey, 71 Dudley Rd, New Brunswick, NJ, 08901, USA
| | | | - Christian Haudenschild
- George Washington University Medical Center, 2121 Eye Street, NW, Washington, DC, 20052, USA
| | - Stuart S Martin
- University of Maryland Baltimore Greenebaum Cancer Center, 655 W. Baltimore St., Baltimore, MD, 21136, USA
| | - Monica Charpentier
- University of Maryland Baltimore Greenebaum Cancer Center, 655 W. Baltimore St., Baltimore, MD, 21136, USA
| | - Saranya Chumsri
- University of Maryland Baltimore Greenebaum Cancer Center, 655 W. Baltimore St., Baltimore, MD, 21136, USA.,Mayo Clinic Cancer Center, 4500 San Pablo Rd., Jacksonville, FL, 32224, USA
| | - Massimo Cristofanilli
- Robert H Lurie Comprehensive Cancer Center, Northwestern University, 645 N Michigan Avenue, Chicago, IL, 60611, USA
| | - Cha-Mei Tang
- Creatv MicroTech, Inc., 11609 Lake Potomac Drive, Potomac, MD, 20854, USA
| | - R Katherine Alpaugh
- Fox Chase Cancer Center, Protocol Support Laboratory, 333 Cottman Ave., Philadelphia, PA, 19111, USA
| |
Collapse
|
358
|
Ferreira MM, Ramani VC, Jeffrey SS. Circulating tumor cell technologies †. Mol Oncol 2016; 10:374-94. [PMID: 26897752 PMCID: PMC5528969 DOI: 10.1016/j.molonc.2016.01.007] [Citation(s) in RCA: 353] [Impact Index Per Article: 44.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/16/2016] [Accepted: 01/19/2016] [Indexed: 02/08/2023] Open
Abstract
Circulating tumor cells, a component of the “liquid biopsy”, hold great potential to transform the current landscape of cancer therapy. A key challenge to unlocking the clinical utility of CTCs lies in the ability to detect and isolate these rare cells using methods amenable to downstream characterization and other applications. In this review, we will provide an overview of current technologies used to detect and capture CTCs with brief insights into the workings of individual technologies. We focus on the strategies employed by different platforms and discuss the advantages of each. As our understanding of CTC biology matures, CTC technologies will need to evolve, and we discuss some of the present challenges facing the field in light of recent data encompassing epithelial‐to‐mesenchymal transition, tumor‐initiating cells, and CTC clusters. We present a comprehensive overview of CTC detection and capture technologies. We provide a conceptual description of strategies used in different technologies. We highlight the key features of individual technologies. We discuss CTC technology performance in the context of clinical studies.
Collapse
Affiliation(s)
- Meghaan M Ferreira
- Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Vishnu C Ramani
- Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Stefanie S Jeffrey
- Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
| |
Collapse
|