Fluid biopsy in patients with metastatic prostate, pancreatic and breast cancers

TLDR

Hematologic spread of carcinoma leads to incurable metastasis, yet the basic characteristics and travel mechanisms of cancer cells in the bloodstream remain unknown. The study aims to develop a fluid‑phase biopsy that detects circulating tumor cells without surface protein enrichment and provides high‑definition images suitable for diagnostic pathology. The authors use an enrichment‑free fluid‑phase assay that captures CTCs and renders them in high‑definition for pathology‑quality imaging. The HD‑CTC assay detected >5 high‑definition CTCs per mL in 80 % of metastatic prostate, 70 % of breast, and 50 % of pancreatic cancer patients, but none in healthy controls, and identified CTC clusters ranging from 2 to over 30 cells in most patients, demonstrating its capacity to detect significant numbers of HD‑CTCs in the majority of these cancers.

Abstract

Hematologic spread of carcinoma results in incurable metastasis; yet, the basic characteristics and travel mechanisms of cancer cells in the bloodstream are unknown. We have established a fluid phase biopsy approach that identifies circulating tumor cells (CTCs) without using surface protein-based enrichment and presents them in sufficiently high definition (HD) to satisfy diagnostic pathology image quality requirements. This 'HD-CTC' assay finds >5 HD-CTCs mL−1 of blood in 80% of patients with metastatic prostate cancer (n = 20), in 70% of patients with metastatic breast cancer (n = 30), in 50% of patients with metastatic pancreatic cancer (n = 18), and in 0% of normal controls (n = 15). Additionally, it finds HD-CTC clusters ranging from 2 HD-CTCs to greater than 30 HD-CTCs in the majority of these cancer patients. This initial validation of an enrichment-free assay demonstrates our ability to identify significant numbers of HD-CTCs in a majority of patients with prostate, breast and pancreatic cancers.