Isolation of single cells for protein therapeutics using microwell selection and Surface Plasmon Resonance imaging

Here the feasibility is demonstrated that by combining Surface Plasmon Resonance Imaging (SPRi) and self-sorting microwell technology product secretion of individual cells can be monitored. Additionally isolation of the selected cells can be performed by punching the cells from the microwells using coordinates of the positions of microwells obtained with SPRi. Cells of interest can be retrieved sterile from the microwell array for further cultivation.

Circulating tumor cells in small-cell lung cancer: a predictive and prognostic factor

BACKGROUND

Initial response of small-cell lung cancer (SCLC) to chemotherapy is high, and recurrences occur frequently, leading to early death. This study investigated the prognostic value of circulating tumor cells (CTCs) in patients with SCLC and whether changes in CTCs can predict response to chemotherapy. Patients and methods In this multicenter prospective study, blood samples for CTC analysis were obtained from 59 patients with SCLC before, after one cycle, and at the end of chemotherapy. CTCs were measured using CellSearch systems.

RESULTS

At baseline, lower numbers of CTCs were observed for 21 patients with limited SCLC (median = 6, range 0-220) compared with 38 patients with extensive stage (median = 63, range 0-14,040). Lack of measurable CTCs (27% of patients) was associated with prolonged survival (HR 3.4; P ≤ 0.001). CTCs decreased after one cycle of chemotherapy; this decrease was not associated with tumor response after four cycles of chemotherapy. CTC count after the first cycle of chemotherapy was the strongest predictor for overall survival (HR 5.7; 95% CI 1.7-18.9; P = 0.004).

CONCLUSION

Absolute CTCs after one cycle of chemotherapy in patients with SCLC is the strongest predictor for response on chemotherapy and survival. Patients with low initial CTC numbers lived longer than those with higher CTCs.

P4-07-01: Circulating Tumor Cells, Disease Recurrence and Survival in Newly Diagnosed Breast Cancer

Background: The presence of circulating tumor cells (CTC) is an independent prognostic factor for progression-free survival and overall survival (OS) for patients with metastatic breast cancer beginning a new line of systemic therapy. The current study was undertaken to explore whether the presence of CTC at the time of diagnosis was associated with recurrence free survival (RFS) and breast cancer related death.

Materials and Methods: In a prospective single center study, CTC were enumerated with the CellSearch system in 4 aliquots of 7.5 ml of peripheral blood of 504 patients before undergoing surgery for breast cancer between September 2003 and January 2009. Four hundred four had stage I-III disease and were followed for 6–90 months (median 48). One hundred had a benign tumor and served as a control group. Results: In the control group 15 (15%) had ≥1 CTC / 30 mL of blood. In stage I-III patients 76 (19%) had ≥1 CTC in 30 mL of blood of whom 16 (21.1%) developed a recurrence. In 328 patients with 0 CTC 38 (11.6%) developed a recurrence. Four year RFS was 88.4% for favorable CTC and 78.9% for unfavorable CTC (p =0.038). Breast cancer related death was 4,3% (14 of 328 patients) for favorable and 14,5% (11 of 76 patients) for unfavorable CTC (p = 0.001). CTC, PR receptor and stage were independent predictors of breast cancer related death in multivariate analysis. The corrected odds ratio after multivariate analysis for breast cancer related death in patiënts with CTC versus patiënts without CTC was 3,47.

Discussion: Presence of CTC in breast cancer patients before undergoing surgery with curative intent is associated with an increased risk for recurrence and breast cancer related death. This supports the notion that the presence of CTC is also important in the primary disease setting. In this study the sensitivity of the CellSearch assay was increased by a fourfold increase in blood volume and a threshold for unfavorable of ≥1 CTC in 30 mL of blood, which lead to a relatively high background in the control group. Thus an increase in specificity is desired before initiation of prospective multicenter trials as well as a more practical way to process larger blood volumes.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-07-01.

Circulating tumour cells during laparoscopic and open surgery for primary colonic cancer in portal and peripheral blood

BACKGROUND

The objective of this study was to detect and quantify circulating tumour cells (CTC) in peripheral and portal blood of patients who had open or laparoscopic surgery for primary colonic cancer.

METHODS

Patients in the laparoscopic-group were operated on in a medial to lateral approach ("vessels first"), in the open-group a lateral to medial approach was applied. The enumeration of CTC was performed with the CellSearch System. Intra-operative samples were taken paired-wise (from peripheral and portal circulation) directly after entering the abdominal cavity (T1), after mobilisation of the tumour baring segment (T2), and after tumour resection (T3). Ploidy of both the CTC and tissue of the primary tumour was determined for chromosome 1, 7, 8 and 17.

RESULTS

Thirty-one patients were included; 18 patients had open surgery, 13 patients were operated on laparoscopically. The percentage of samples with CTC at T1 was 7% in peripheral blood and 54% in portal blood (p=0.002). At T2, 4% and 31% respectively (p=0.031). And at T3, 4% and 26% respectively (p=0.125). The cumulative percentage of samples with CTC was significantly higher during open surgery as compared to the laparoscopic approach. Both the CTC and tissue of the primary tumour were diploid for chromosome 1, 7, 8 and 17.

CONCLUSION

The detection rate and quantity of CTC is significantly increased intra-operatively and is significantly higher in portal blood compared to peripheral blood. Significantly less CTC were detected during laparoscopic surgery probably as result of the medial to lateral approach.