Clinical Chemistry · 2012 · 102 citations · 28 references
EngineeringBioengineeringBiomedical EngineeringBiomemsMetastasisNanomaterialsCirculating Tumor CellsLiquid BiopsyMicrofluidicsCirculating Tumor Cell EnumerationPersonalized Cancer MedicinePersonalized Cancer TreatmentSelectin-mediated AdhesionSelectin-mediated InteractionsSurface Functionalized NanomaterialsWhole Blood CollectionWhole Blood Separation
BACKGROUND: Circulating tumor cells (CTCs) can be used clinically to treat cancer. As a diagnostic tool, the CTC count can be used to follow disease progression, and as a treatment tool, CTCs can be used to rapidly develop personalized therapeutic strategies. To be effectively used, however, CTCs must be isolated at high purity without inflicting cellular damage. METHODS: We designed a microscale flow device with a functionalized surface of E-selectin and antibody molecules against epithelial markers. The device was additionally enhanced with a halloysite nanotube coating. We created model samples in which a known number of labeled cancer cells were suspended in healthy whole blood to determine device capture efficiency. We then isolated and cultured primary CTCs from buffy coat samples of patients diagnosed with metastatic cancer. RESULTS: Approximately 50% of CTCs were captured from model samples. Samples from 12 metastatic cancer patients and 8 healthy participants were processed in nanotube-coated or smooth devices to isolate CTCs. We isolated 20-704 viable CTCs per 3.75-mL sample, achieving purities of 18%-80% CTCs. The nanotube-coated surface significantly improved capture purities (P = 0.0004). Experiments suggested that this increase in purity was due to suppression of leukocyte spreading. CONCLUSIONS: The device successfully isolates viable CTCs from both blood and buffy coat samples. The approximately 50% capture rate with purities >50% with the nanotube coating demonstrates the functionality of this device in a clinical setting and opens the door for personalized cancer therapies.
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Isolation of rare circulating tumour cells in cancer patients by microchip technology
Sunitha Nagrath, Lecia V. Sequist, Shyamala Maheswaran et al. · Nature · 2007 · 3.5K citations · Full text
Medicine, Cancer Biology, Oncology +15