Clinical OMICS

NOV-DEC 2018

Healthcare magazine for research scientists, labs, pathologists, hospitals, cancer centers, physicians and biopharma companies providing news articles, expert interviews and videos about molecular diagnostics in precision medicine

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Page 21 of 51

Camille Mojica Rey, Ph.D. Contributing Editor Liquid Logic Diagnostic Approaches Employing Circulating Tumor Cells Show Steady Advances W idespread study of circulating tumor cells (CTCs) began in the early 2000s. Since then, the goal has been to replace expensive and invasive surgical biopsies with relatively simple and inexpensive CTC-based liquid biop- sies. However, the translation of CTC-based liquid biopsy technology from research labs to the clinic has been moving forward slowly. A review published this year in Current Oncology Reports on the use of liquid biopsies in metastatic prostate cancer listed 15 platforms as examples of those used in research for CTC enrichment and detection. Yet, CellSearch, cleared by the FDA in 2008 for CTC enumeration, has been the only platform approved for clinical use in the past decade. And it is only approved for use in breast, prostate, and colorectal cancer patients. Currently, physicians use CellSearch to count the number of CTCs in a 7.5-mL sam- ple of blood. These counts have proven useful in prognosis and monitoring in the three types of cancer for which the technology is approved. In advanced prostate cancer, for example, 5 or more cells in a 7.5-mL sample has been shown to be asso- ciated with a worse prognosis. Physicians also use continuous counts of CTCs in monitoring the efficacy of a treatment. Though useful, this is far from fulfilling the promise of CTCs. Researchers are hoping recent clinical findings will help move CTC-based liquid biopsies into the clinic more quickly. In addition to counting CTCs, they are now char- acterizing them and using that information to successfully make treatment decisions. Physician researchers are investigating the use of multi-parametric tests that will uti- lize both CTCs along with another blood-borne analyte—circulating tumor DNA (ctDNA). In addition, biotech companies, in col- laboration with academic researchers, are working to introduce new, more sensitive CTC retrieval plat- forms—and get them FDA approved. Characterizing CTCs In a study published in July in JAMA Oncology, researchers from Memorial Sloan Kettering Cancer Center, the Royal Michael Melchiorre / Getty Images

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