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Zeinali M, Huang W, Lee M, Nadhan A, Mathur A, Hedman C, Lin E, Harouaka R, Wicha MS, Zhao L, Palanisamy N, Hafner M, Reddy R, Kalemkerian GP, Schneider BJ, Hassan KA, Ramnath N, Nagrath S. Abstract B45: High-throughput label-free isolation and expansion of circulating tumor cells (CTCs) from non-small cell lung cancer (NSCLC) patients for personalized treatments. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.liqbiop20-b45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Circulating tumor cell (CTC) clusters are emerging as clinically significant harbingers of metastases in solid organ cancers. Prior to engaging these CTC clusters in animal models of metastases, it is imperative for technology to identify them with high sensitivity. These clusters often present heterogeneous surface markers, and current methods for isolation of clusters may fall short.
Methods: We have applied the inertial microfluidic Labyrinth device for high-throughput, biomarker-independent, size-based isolation of CTCs and CTC clusters from patients with metastatic non-small cell lung cancer (NSCLC).
Results: Using the Labyrinth device, CTCs (PanCK+/DAPI+/CD45-) were isolated from metastatic NSCLC patients (n=25). Heterogeneous CTC populations were detected, including CTCs expressing epithelial (EpCAM), mesenchymal (vimentin), or both markers. CTCs were isolated from 100% of patients (417±1023 CTCs/mL), and CTCs that were EpCAM negative were significantly higher in numbers than EpCAM+ CTCs. Cell clusters of ≥2 CTCs were observed in 96% of patients, of which 75% were negative for EpCAM. Patients with higher number of CTC clusters than single CTCs had worse progression-free survival (PFS) (p=0.05). Recovered CTCs from patients with RET, ROS1, and ALK-rearranged tumors revealed identical genetic aberrations as the primary tumor for each gene using FISH analysis. We have successfully expanded the recovered CTCs from 2 patients and screened for therapeutic targeting. We have found that TPX-0005 might be effective in these patients and would direct them to a clinical trial using this compound.
Conclusions: The label-free Labyrinth device demonstrated the capability of collecting recovered CTCs from the device using a continuous processing technique while in a suspension state. This advantage opens the opportunities not only for CTC expansion off-chip, but also for ex vivo drug testing to direct patient-specific therapies.
Citation Format: Mina Zeinali, Wei Huang, Maggie Lee, Arthi Nadhan, Anvya Mathur, Casey Hedman, Eric Lin, Ramdane Harouaka, Max S. Wicha, Lili Zhao, Nallasivam Palanisamy, Mathias Hafner, Rishindra Reddy, Gregory P. Kalemkerian, Bryan J. Schneider, Khaled A. Hassan, Nithya Ramnath, Sunitha Nagrath. High-throughput label-free isolation and expansion of circulating tumor cells (CTCs) from non-small cell lung cancer (NSCLC) patients for personalized treatments [abstract]. In: Proceedings of the AACR Special Conference on Advances in Liquid Biopsies; Jan 13-16, 2020; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(11_Suppl):Abstract nr B45.
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Affiliation(s)
| | - Wei Huang
- 1University of Michigan, Ann Arbor, MI,
| | | | | | | | | | - Eric Lin
- 1University of Michigan, Ann Arbor, MI,
| | | | | | - Lili Zhao
- 1University of Michigan, Ann Arbor, MI,
| | | | - Mathias Hafner
- 2Institute for Medical Technology of Heidelberg University, Mannheim, Germany
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Zeinali M, Lee M, Nadhan A, Mathur A, Hedman C, Lin E, Harouaka R, Wicha MS, Zhao L, Palanisamy N, Hafner M, Reddy R, Kalemkerian GP, Schneider BJ, Hassan KA, Ramnath N, Nagrath S. High-Throughput Label-Free Isolation of Heterogeneous Circulating Tumor Cells and CTC Clusters from Non-Small-Cell Lung Cancer Patients. Cancers (Basel) 2020; 12:cancers12010127. [PMID: 31947893 PMCID: PMC7016759 DOI: 10.3390/cancers12010127] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/17/2019] [Accepted: 12/30/2019] [Indexed: 11/25/2022] Open
Abstract
(1) Background: Circulating tumor cell (CTC) clusters are emerging as clinically significant harbingers of metastases in solid organ cancers. Prior to engaging these CTC clusters in animal models of metastases, it is imperative for technology to identify them with high sensitivity. These clusters often present heterogeneous surface markers and current methods for isolation of clusters may fall short. (2) Methods: We applied an inertial microfluidic Labyrinth device for high-throughput, biomarker-independent, size-based isolation of CTCs/CTC clusters from patients with metastatic non-small-cell lung cancer (NSCLC). (3) Results: Using Labyrinth, CTCs (PanCK+/DAPI+/CD45−) were isolated from patients (n = 25). Heterogeneous CTC populations, including CTCs expressing epithelial (EpCAM), mesenchymal (Vimentin) or both markers were detected. CTCs were isolated from 100% of patients (417 ± 1023 CTCs/mL). EpCAM− CTCs were significantly greater than EpCAM+ CTCs. Cell clusters of ≥2 CTCs were observed in 96% of patients—of which, 75% were EpCAM−. CTCs revealed identical genetic aberrations as the primary tumor for RET, ROS1 , and ALK genes using fluorescence in situ hybridization (FISH) analysis. (4) Conclusions: The Labyrinth device recovered heterogeneous CTCs in 100% and CTC clusters in 96% of patients with metastatic NSCLC. The majority of recovered CTCs/clusters were EpCAM−, suggesting that these would have been missed using traditional antibody-based capture methods.
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Affiliation(s)
- Mina Zeinali
- Chemical Engineering, University of Michigan, 2800 Plymouth Road, NCRC, Building 20-3rd Floor, Ann Arbor, MI 48109, USA; (M.Z.); (M.L.); (A.N.); (A.M.); (E.L.)
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, NCRC B10-A184, Ann Arbor, MI 48109, USA
- Institute for Medical Technology of Heidelberg University & University of Applied Sciences Mannheim, Paul-Wittsack-Straße 10, 68163 Mannheim, Germany;
| | - Maggie Lee
- Chemical Engineering, University of Michigan, 2800 Plymouth Road, NCRC, Building 20-3rd Floor, Ann Arbor, MI 48109, USA; (M.Z.); (M.L.); (A.N.); (A.M.); (E.L.)
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, NCRC B10-A184, Ann Arbor, MI 48109, USA
| | - Arthi Nadhan
- Chemical Engineering, University of Michigan, 2800 Plymouth Road, NCRC, Building 20-3rd Floor, Ann Arbor, MI 48109, USA; (M.Z.); (M.L.); (A.N.); (A.M.); (E.L.)
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, NCRC B10-A184, Ann Arbor, MI 48109, USA
| | - Anvya Mathur
- Chemical Engineering, University of Michigan, 2800 Plymouth Road, NCRC, Building 20-3rd Floor, Ann Arbor, MI 48109, USA; (M.Z.); (M.L.); (A.N.); (A.M.); (E.L.)
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, NCRC B10-A184, Ann Arbor, MI 48109, USA
| | - Casey Hedman
- Molecular, Cellular, and Developmental Biology, University of Michigan, 1105 North University Avenue, 2220 Biological Science Building, Ann Arbor, MI 48109, USA;
| | - Eric Lin
- Chemical Engineering, University of Michigan, 2800 Plymouth Road, NCRC, Building 20-3rd Floor, Ann Arbor, MI 48109, USA; (M.Z.); (M.L.); (A.N.); (A.M.); (E.L.)
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, NCRC B10-A184, Ann Arbor, MI 48109, USA
| | - Ramdane Harouaka
- Department of Internal Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA; (R.H.); (M.S.W.); (G.P.K.); (B.J.S.); (K.A.H.)
| | - Max S. Wicha
- Department of Internal Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA; (R.H.); (M.S.W.); (G.P.K.); (B.J.S.); (K.A.H.)
| | - Lili Zhao
- Biostatistics Department, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Nallasivam Palanisamy
- Department of Urology, Henry Ford Health System, 1 Ford Place, Room 2D26, Detroit, MI 48202, USA;
| | - Mathias Hafner
- Institute for Medical Technology of Heidelberg University & University of Applied Sciences Mannheim, Paul-Wittsack-Straße 10, 68163 Mannheim, Germany;
| | - Rishindra Reddy
- Department of Surgery, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA;
| | - Gregory P. Kalemkerian
- Department of Internal Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA; (R.H.); (M.S.W.); (G.P.K.); (B.J.S.); (K.A.H.)
| | - Bryan J. Schneider
- Department of Internal Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA; (R.H.); (M.S.W.); (G.P.K.); (B.J.S.); (K.A.H.)
| | - Khaled A. Hassan
- Department of Internal Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA; (R.H.); (M.S.W.); (G.P.K.); (B.J.S.); (K.A.H.)
| | - Nithya Ramnath
- Department of Internal Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA; (R.H.); (M.S.W.); (G.P.K.); (B.J.S.); (K.A.H.)
- Veterans Administration Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA
- Correspondence: (N.R.); (S.N.); Tel.: +734-936-9015 (N.R.); +734-647-7985 (S.N.)
| | - Sunitha Nagrath
- Chemical Engineering, University of Michigan, 2800 Plymouth Road, NCRC, Building 20-3rd Floor, Ann Arbor, MI 48109, USA; (M.Z.); (M.L.); (A.N.); (A.M.); (E.L.)
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, NCRC B10-A184, Ann Arbor, MI 48109, USA
- Correspondence: (N.R.); (S.N.); Tel.: +734-936-9015 (N.R.); +734-647-7985 (S.N.)
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Zeinali M, Lee M, Nadhan A, Mathur A, Huang W, Lin E, Harouaka R, Wicha MS, Palanisamy N, Hafner M, Reddy R, Kalemkerian GP, Schneider BJ, Hassan KA, Ramnath N, Nagrath S. Abstract 1332: High Throughput isolation and expansion of circulating tumor cells (CTCs) from Non-small cell lung cancer (NSCLC) patients for personalized treatments. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-1332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Circulating tumor cells (CTCs) have emerged as important blood-based surrogate markers of primary tumors. Current methods for isolation of lung CTCs mostly rely on biomarker dependent antibody-based capture, missing populations that may be stem-like in nature. Results: We have applied the microfluidic Labyrinth device for high throughput, label-free, size-based isolation of CTCs from non-small cell lung cancer patients (NSCLC). The Labyrinth device was optimized and tested for inertial separation of cancer cells using the human lung cancer cell line H1650. The recovery and purity were >82% and >78%, respectively, operating at a flow rate of 2.5 mL/min. Using the biomarker-independent Labyrinth separation device, heterogeneous CTC populations were isolated from metastatic NSCLC patients (n=21). Heterogeneous CTC populations were detected, including CTCs (PanCK+ and CD45-), CTCs expressing EpCAM or Vimentin, and CTCs expressing both markers representing an EMT-like population of CTCs. Using Labyrinth, we were able to isolate CTCs from 100% of patients with an average yield of 180±168 CTCs/mL. Among the captured CTCs, EpCAM- CTCs were significantly more common than EpCAM+ CTCs (115.7 vs. 39.1 CTCs/mL respectively). Cell clusters of 2 or more CTCs were also observed in 95% of patients; 79% of these clusters were negative for EpCAM expression, whereas 35% expressed Vimentin, suggestive of an EMT phenotype. Recovered CTCs from patients with RET, ROS1 and ALK rearranged tumors showed aberrations matching with the primary tumor for each gene using FISH analysis. We have successfully expanded the recovered CTCs from 2 patients and screened for therapeutic targeting. We have found that TPX-0005 might be effective in these patients and would direct them to a clinical trial using this compound. Conclusion: The label-free Labyrinth device demonstrated the capability of collecting recovered CTCs from the device using a continuous processing technique while in a suspension state. This advantage opens the opportunities not only for CTC expansion off-chip, but also for ex-vivo drug testing to direct patient-specific therapies.
Citation Format: Mina Zeinali, Maggie Lee, Arthi Nadhan, Anvya Mathur, Wei Huang, Eric Lin, Ramdane Harouaka, Max S. Wicha, Nallasivam Palanisamy, Mathias Hafner, Rishindra Reddy, Gregory P. Kalemkerian, Bryan J. Schneider, Khaled A. Hassan, Nithya Ramnath, Sunitha Nagrath. High Throughput isolation and expansion of circulating tumor cells (CTCs) from Non-small cell lung cancer (NSCLC) patients for personalized treatments [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1332.
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Affiliation(s)
| | | | | | | | - Wei Huang
- 1University of Michigan, Ann Arbor, MI
| | - Eric Lin
- 1University of Michigan, Ann Arbor, MI
| | | | | | | | - Mathias Hafner
- 3Institute for Medical Technology of Heidelberg University & University of Applied Sciences Mannheim, Mannheim, Germany
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