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CTCs track progression across early-stage breast cancer molecular subtypes. Publications 6 June 2023 ASCO 2023: Circulating tumor cells (CTCs) detection and isolation in different subtypes of early-stage breast cancer patients from Bangladesh. A trial found CTCs in 60% of early-stage breast cancer patients, notably all HER2-positive cases, linking them to tumor grade. Send the next! Background Breast cancer is a highly heterogeneous pathophysiology characterized by poor outcomes. Due to the increasing incidence and disease progression rates and undefined relapse periods, reliable disease monitoring is a challenge and has remained an unmet need. Advancements in liquid biopsy have significantly enhanced our understanding of clinical oncology. CTC-based liquid biopsy is emerging as a reliable prognostic tool to predict various clinical indicators. Although extensively investigated in metastatic breast cancers, little is known about CTCs in early-stage breast cancers. CTCs with respect to different molecular subtypes of breast cancer in early-stage breast cancer patients is evaluated. Methods In this prospective clinical trial (CMC 59.27.0000.013.19 PG.009.2022/262), 40 early-stage patients with luminal (A + B, 33.33%), HER2-positive (12.8%), triple-negative (12.8%), and undetermined (41.07%) subtypes were recruited. CTCs were isolated in 1.5 ml blood using the Drug Controller General of India approved OncoDiscover CTC test. This platform contains affinity-based magnetic nanoparticles to mediate EpCAM-based CTC isolation. CTCs were detected as CK18+, DAPI+, and CD45- cells using a fluorescence detection-based automated digital imaging platform. Results CTCs were detected in 60% of patients with a mean CTC count of 1 cell / 1.5 ml blood. Among total positive patients, the luminal subtype was the least positive (46%), followed by TNBC (60%) and undetermined (62.5%) subgroups, while all HER2-positive patients showed the presence of CTCs. Besides individual cells, CTC clusters were detected in 12.5% of patients, and they were equally distributed in luminal and HER2-positive subpopulations. When analyzed on the scale of tumor grade, grade I patients did not show the presence of CTCs, while 58.33% of grade II patients had ≥ 1 CTC. All grade III patients showed the presence of ≥ 1 CTC. CTC count was high among CTC-positive grade II patients (average 2 CTCs) and correlated well with the presence of CTC clusters in these patients. Patients who had surgical intervention had a low CTC burden compared to patients who did not have a surgical resection. 75% of treatment-naive patients showed the presence of CTCs, while 58% of patients receiving chemotherapy alone showed the presence of 1 CTC. 50% of patients who had surgery followed by CT + RT showed the presence of 1 CTC. Conclusions The presence of CTCs may suggest the biological progression of disease in early-stage BC patients. CTCs detected in all HER2-positive patients suggested the high shedding nature of these tumors, which correlates well with their reported migratory tendency. The presence of CTCs did not show a clear correlation with the treatment regimen. However, this data is based on a single time point and needs longitudinal correlation with CTCs on a larger sample size. Clinical Trial Information 59.27.0000.013.19 PG.009.2022/262. Know more Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

PD-L1 expressing CTCs help monitor pancreatic cancer progression and MRD. Publications 25 November 2024 ISLB 2024: Expression of Programmed Death - Ligand 1 as a dynamic biomarker on circulating tumor cells in pancreatic cancer patients CTC detection with PD-L1 overexpression reveals aggressive pancreatic cancer and potential biomarker value for monitoring metastasis and disease progression. Introduction Pancreatic cancer shows a high mortality rate due to difficulties in early diagnosis and the absence of standardized guidelines for assessing suspicious pancreatic masses. Biomarkers such as carcinoembryonic antigen (CEA) and CA19-9 lack sufficient sensitivity and specificity for pancreatic cancer detection. While tissue biopsy provides a static signature of target protein expressions, including PD-L1, the enumeration and profiling of circulating tumor cells (CTCs) with cell surface markers can offer actionable targets for treatment. We present findings in pancreatic cancer where CTCs are associated with overexpression of PD-L1 as a dynamic marker for monitoring minimal residual disease (MRD) and disease progression, highlighting its role in the metastatic cascade. Methods Retrospectively, 50 pancreatic cancer patients were investigated for the presence of CTCs. Among them, 12 patients (24%) were in the early stage of disease, with ages ranging from 35 to 75 years. Sixty percent of patients were male (n = 30) and 40% were female (n = 20), while 76% (n = 38) were classified as late-stage cases. PD-L1 expression was evaluated using the approved OncoDiscover platform, which utilizes multi-component systems conjugated with anti-EpCAM antibodies on magnetic nanoparticles. CTC enumeration was performed using CD45–, EpCAM+, DAPI+, and CK18+ markers in 1.5 ml of peripheral blood. Functional assays assessed PD-L1 overexpression on CTCs using automated motorized Zeiss fluorescence microscopy. The sensitivity of the CTC and PD-L1 assay had been previously evaluated in other solid cancers. Results Out of 50 pancreatic cancer patients, 74% (n = 37) had at least one detectable CTC. Among these patients, 51% (n = 19) had one CTC, 30% (n = 11) had two CTCs, 14% (n = 5) had three CTCs, and 5% (n = 2) had four CTCs. The mean number of CTCs and clusters was 1.28 and 0.16, respectively. Additionally, 92% (n = 34) of patients demonstrated PD-L1 expression on CTCs. CTC clusters were observed in 19% of patients (n = 7). The mean PD-L1 expression on CTCs was 1.14. Conclusions CTCs with PD-L1 overexpression strongly suggest poor prognosis, potentially linked to activation of the metastatic cascade through immune system evasion. Larger studies are required to validate whether PD-L1-positive CTCs can serve as a reliable biomarker for the diagnosis and management of pancreatic cancer. View Publication Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe