OncoDiscover Available in India | Dr. Jayant Khandare Expert Insights 9 August 20222 OncoDiscover Available in India | Dr. Jayant Khandare OncoDiscover Available in India | Dr. Jayant Khandare This test is made available and accessible in India. And this is what this simple and completely painless blood test has been clinically validated in a study of thousands of patients with the support of Tata memorial hospital, now being used by many oncologists to monitor their patients so as to give their better treatment options, and to know if the cancer patient is completely disease free. 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

Actorius featured on BBC News Click Kannada with expert and patient insights. Press Release 22 March 2019 Actorius Innovations Featured on BBC News Click Kannada Actorius Innovations and Research was showcased on BBC News Click (Kannada edition), featuring an interview with Dr. Jayant Khandare and testimonials from leading oncologists including Dr. Kumar Prabhash and Dr. Pankaj Chaturvedi, along with patient experiences. In this special feature on BBC News Click Kannada, Actorius Innovations and Research highlights its advancements in cancer diagnostics and liquid biopsy technology. Dr. Jayant Khandare shares insights into the science and vision behind the innovation, while renowned experts Dr. Kumar Prabhash and Dr. Pankaj Chaturvedi provide clinical perspectives on its impact. The segment also includes powerful patient testimonials, underscoring the real-world significance of early and minimally invasive cancer detection. Watch the video 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

Self-propelled CNT microrockets enable rapid capture and isolation of CTCs. Publications 13 April 2015 Manuscript: Self-propelled Carbon Nanotube Based Microrockets for Rapid Capture and Isolation of Circulating Tumor Cells Self-propelled CNT microrockets rapidly capture and magnetically isolate circulating tumor cells, enabling faster liquid biopsy and early cancer detection. We demonstrated a novel carbon nanotube (CNT)-based microrocket that propels efficiently through the thrust generated by oxygen (O₂) bubbles. These self-propelled microrockets exhibit ultrafast propulsion in aqueous solutions as well as in Dulbecco’s modified Eagle’s medium (DMEM). The microrocket generated a driving force of over 231 and 300 pN in DMEM containing 4% hydrogen peroxide (H₂O₂). The speed and distance traveled by the microrocket can be controlled by adjusting the concentration of H₂O₂. The designed multifunctional microrocket has the ability to (i) rapidly target (~5 minutes) and efficiently capture (~85%) transferrin receptor–positive (TfR⁺) cancer cells from an artificial CTC-like suspension, (ii) magnetically isolate the captured cells from peripheral blood cells, and (iii) enable subsequent high-resolution imaging. We envision that such self-powered micromotors could provide a novel and effective approach for the rapid and efficient extraction of circulating tumor cells (CTCs) from biological fluids, supporting early cancer diagnosis and detection of recurrence. View Manuscript 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

Magnetically activated nanocellulose enables efficient CTC capture in head & neck cancer. Publications 20 September 2023 Manuscript: Magnetically-activated, nanostructured cellulose for efficient capture of CTCs from the blood sample of head and neck cancer patients Study compares CNC and CNF cellulose nanostructures for EpCAM-based CTC capture in head and neck cancer, enabling affordable real-time cancer monitoring. In this report, the relative efficiency of cellulose nanocrystals (CNCs) and nanofibers (CNFs) to capture circulating tumor cells (CTCs) from the blood samples of head and neck cancer (HNC) patients was evaluated. Detection and enumeration of CTCs are critical for monitoring cancer progression. Both types of nanostructured cellulose were chemically modified with epithelial cell adhesion molecule (EpCAM) antibody and iron oxide nanoparticles. The EpCAM antibody facilitated the engagement of CTCs, promoting their entrapment within the cellulose cage structure. Iron oxide nanoparticles, on the other hand, rendered the cages magnetically activatable, enabling the capture and separation of entrapped CTCs using a magnet. The efficiency of the network structures was demonstrated using blood samples from head and neck cancer patients. It was observed that the degree of chemical functionalization of hydroxyl groups within the CNCs or CNFs with anti-EpCAM determined the efficiency of the system’s interaction with CTCs. Furthermore, the results indicated that the inflexible scaffolds of nanocrystals interacted more efficiently with CTCs than the fibrous CNF scaffolds. Network structures derived from CNCs demonstrated comparable CTC-capturing efficiency to the commercial standard, OncoDiscover®. The findings of this work provide chemical design principles for cellulosic materials intended to construct affordable platforms for monitoring cancer progression in real time. View Manuscript 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

Preoperative CTC levels predict prognosis and survival in oral squamous cell carcinoma. Publications 1 July 2022 Manuscript: Circulating tumor cells as a predictor for poor prognostic factors and overall survival in treatment nay¨ve oral squamous cell carcinoma patients Preoperative circulating tumor cell levels strongly correlate with metastasis, disease severity, and reduced survival in oral squamous cell carcinoma patients. Objective: The aim of this study was to investigate the presence of circulating tumor cells (CTCs) and their correlation with prognostic factors and clinical outcomes in treatment-naive patients with oral squamous cell carcinoma. Study design: CTCs were isolated using the OncoDiscover technique from presurgically obtained peripheral blood of 152 patients with treatment-naive oral squamous cell carcinoma. Sensitivity analysis was performed by including 40 healthy controls. CTC cutoff values for clinicopathologic factors were obtained from receiver operating characteristic curves. Multivariate models determined the significance of CTCs as independent variables. Kaplan–Meier analysis differentiated overall survival based on CTC values corresponding to disease stage. Results: Sensitivity, specificity, and accuracy of CTC detection were 94.32%, 98%, and 95.17%, respectively. The platform differentiated true positives at >3.5 CTCs (P < .00001). CTC counts above 20.5 were suggestive of nodal metastasis (P < .0001), with a linear trend for detecting occult metastasis (P = .061). Early and advanced stages could be differentiated by >13.5 CTCs (P < .0001). Elevated CTC levels were significantly associated with extranodal extension (>21.45 CTCs, P = .025), perineural invasion (>19.35 CTCs, P = .049), and depth of invasion (>12.5 CTCs, P = .0038). Median survival was reduced by 19 months when CTC levels were >13. Conclusions: Preoperative CTC levels demonstrated a strong correlation with adverse clinicopathologic factors and suggested their role as a sensitive prognostic marker for predicting survival outcomes and disease progression. (Oral Surg Oral Med Oral Pathol Oral Radiol 2022;134:73–83) View Manuscript 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

AI-based image analysis rapidly profiles CTC morphology and biomarker expression. Publications 16 September 2025 Profiling of PD-L1 and HER2 over expression on cancer cells using AI based macro-driven automation AI-based image analysis rapidly profiles circulating tumor cells, quantifying morphology and biomarkers like PD-L1 and HER2 for cancer research. Abstract Background Extravasation, invasion, epithelial-to-mesenchymal transitions, metastasis progression, immune evasion, and therapeutic resistance are driven by phenotypic alterations in cancer cells. Assessing cell morphology, stiffness, and deformability is therefore crucial. The expression of PD-L1, HER2, EGFR, and cytokeratins (CKs) serves as key phenotypic biomarkers for precision oncology. We developed an AI-based image analysis tool that rapidly captures these transitions in cell assays, including specific protein biomarkers expressed on circulating tumor cells (CTCs). Methods We extended an ImageJ macro to enable rapid and reproducible extraction of biophysical parameters. The macro processes .lif, .nd2, and .czi file formats, using DAPI for nuclear segmentation and fluorophore-conjugated antibodies to delineate cytoplasmic boundaries. We evaluated automatic channel detection, intensity normalization, Otsu thresholding, and per-cell quantification of parameters such as surface area, circularity index (CI), and mean fluorescence intensity. Violin plots illustrated temporal variations in CI across A549 and MCF7 cells. Validation was conducted on CTCs isolated from cancer patient samples (n = 100) for PD-L1 and HER2 expression. Results The macro reduced image processing time from 7 minutes to 3 seconds per sample. A549 cells showed higher and more consistent CI values across all time points, while MCF7 cells demonstrated lower CI with greater variability, particularly at 24 and 72 hours. Quantitative measurements of PD-L1 and HER2 expression showed 100% concordance between the ImageJ macro and Zeiss software outputs, confirming analytical accuracy. CK18 intensity (~60–400) and PD-L1 (~20–50) levels measured by both platforms validated the macro’s ability to detect a wide range of marker expression in CTC subsets. CTCs exhibited higher CI values and greater morphological heterogeneity, consistent with their invasive phenotype. Conclusions We present an AI-driven macro that quantifies the biophysical characteristics of cancer cells, enabling precise phenotypic profiling, including circularity index, proliferation rates, and overexpression of biomarkers such as PD-L1 and HER2 in both cultured cell lines and patient-derived CTCs. 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

CTCs track residual disease and therapy response in breast cancer patients. Publications 6 June 2023 ASCO 2023: Effect of circulating tumor cells distribution in treatment naive and treated patients with advance stage breast cancer on disease burden. A study of 417 breast cancer patients shows tracking circulating tumor cells (CTCs) effectively monitors therapy response and recurrence risk. Background Breast malignancies are a leading cause of cancer-related mortalities and show an ascending incidence rate. Despite advancements in our understanding of the disease, its clinical outcome is often dismal. This largely remains owing to the characteristic wide window of relapse, spanning months to decades after primary treatment. Therefore, continuous monitoring of the disease is an offered choice to detect metastatic progression and recurrence. Circulating tumor cells (CTCs) have emerged as a powerful prognostic tool to predict the disease outcome in many epithelial cancers. CTCs are a real-time surrogate biomarker accounting for minimal residual disease (MRD) which is often missed in CT PET scanning. This leads to a progression of metastasis when the patient is often considered as 'clinically disease free'. Here, we analyzed the presence of CTCs in treatment-naive and chemo-recipient breast cancer patients. Methods In this retrospective study on 417 breast cancer patients, CTCs were isolated from 1.5 ml of blood using the Drug Controller General of India (DCGI) 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 based on an automated digital imaging platform. Results 42.6% (n=178) of patients were clinically at a progressive stage (stage II and III) and treatment-naive. On the other hand, 47.4% of patients received treatment including surgery and chemotherapy. CTCs were not observed in 5.6% (n=10) of the treatment-naive population, while 32% (n=75) of patients who received therapy did not show CTCs. The mean CTC number in treatment-naive patients was 15, while the mean CTC count in patients receiving therapy was drastically reduced to 2. This implied that therapy effectively countered the tumor progression and reduced the shedding of tumor cells in circulation. The distribution of CTC in treatment-naive patients exhibited a bimodal trend centered at values of 10 and 50, suggesting two distinct populations of patients with respect to CTC count. CTC count did not show any correlation with the age in both population groups. Surprisingly, CTC count in younger patients (20-50 years) was 50% higher compared to the older population (50-75 years). Conclusions The presence of CTCs in treatment-naive, progressive breast cancer patients indicated biologically aggravated disease. Although therapeutic intervention drastically reduced the CTC burden, their presence in a large population was suggestive of an MRD and the likelihood of recurrence after discontinuation of therapy. A distinct pattern of CTC occurrences in Tx naive and Tx recipient patients suggested that CTCs can be an important clinical indicator to monitor the therapy response, progression, and residual disease. 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

Bioinspired Materials for Wearable Devices and Point-of-Care Testing of Cancer Publications 27 April 2022 Manuscript: Bioinspired Materials for Wearable Devices and Point-of-Care Testing of Cancer Raj Shankar Hazra, Md Rakib Hasan Khan, Narendra Kale, Tabassum Tanha, Jayant Khandare, Sabha Ganai, and Mohiuddin Quadir* Wearable, point-of-care diagnostics, and biosensors are on the verge of bringing transformative changes in detection, management, and treatment of cancer. Bioinspired materials with new forms and functions have frequently been used, in both translational and commercial spaces, to fabricate such diagnostic platforms. Engineered from organic or inorganic molecules, bioinspired systems are naturally equipped with biorecognition and stimuli-sensitive properties. Mechanisms of action of bioinspired materials are deeply connected with thermodynamically or kinetically controlled self-assembly at the molecular and supramolecular levels. Thus, integration ofbioinspired materials into wearable devices, either as triggers or sensors, brings about unique device properties usable for detection, capture, or rapid readout for an analyte of interest. In this review, we present the basic principles and mechanisms of action of diagnostic devices engineered from bioinspired materials, describe current advances, and discuss future trends of the field, particularly in the context of cancer. View Manuscript 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

CTC and PD-L1 detection reveals residual disease despite clear radiological scans. Publications 4 June 2024 ASCO 2024: Effect of circulating tumor cells in clinically stable patients on the conundrum of recurrence with cellular residual disease. CTC detection with PD-L1 expression reveals residual disease despite negative radiological findings in treated cancer patients. Background Despite no evidence of disease by radiological imaging, up to 30% of breast cancer cases are known to relapse after treatment with curative intent. The presence of circulating tumor cells (CTCs) in stage I–II cancer patients signals the activation of extravasation and invasion processes leading to micro-metastasis and may result in poor outcomes. CTCs in blood circulation at any stage of cancer indicate detectable minimal cellular disease (MCD). Thus, the longitudinal investigation of patients with such biomarkers remains highly important for predicting recurrence, therapy escalation, and dose modifications. The expression of programmed death-ligand 1 (PD-L1) on CTCs is a dynamic biomarker, and these cells may escape elimination by the immune system, indicating progression toward a metastatic phenotype. Methods Retrospectively, a cohort of 20 cancer patients (including lung, colorectal, breast, stomach, etc.) who had recently undergone treatment were investigated for the presence of CTCs using the CDSCO-approved OncoDiscover platform. The platform contains multi-component systems conjugated with anti-EpCAM antibodies on magnetic nanoparticles. All patients clinically represented stable disease based on previous radiological findings. CTC enumeration was performed using CD45-, EpCAM+, and CK18+ markers, along with the evaluation of PD-L1 overexpression in 1.5 ml of peripheral blood using automated motorized Zeiss fluorescence microscopy. Results Despite no radiological evidence of disease and clinically stable status, 75% (n = 15) of the selected patients showed at least one CTC. Among them, 55% (n = 11) had one CTC, 5% (n = 1) had two CTCs, and 15% (n = 3) had three CTCs. In addition, 50% (n = 10) of patients demonstrated PD-L1 expression on CTCs, while one patient exhibited a CTC cluster. Conclusions Patients showed circulating residual disease (CRD) despite clinically stable disease, indicating possible progression from localized to secondary disease. Longitudinal monitoring of CTCs with PD-L1 expression may reveal real-time residual disease, progression, regression, and actual response to treatment. CRD monitoring can improve curative outcomes by potentially enhancing progression-free survival (PFS) and overall survival (OS) in solid cancers. 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

ML models using CTCs predict surgery and adjuvant therapy success in HNSCC. Publications 7 June 2022 ASCO 2022: Machine learning (ML)–enabled, circulating tumor cell–based classification of patients for non-prerequisite adjuvant therapy. An XGBoost ML model using CTCs and clinical data achieved 84% accuracy in predicting the need for adjuvant therapy in 380 HNSCC patients. Background Oncology implicates the highest precision using next-generation diagnostics and progressive therapies assisted by predictive tools. If validated clinically, machine learning (ML) can provide better insights in precision oncology. Furthermore, it may longitudinally stratify the progression of cancer disease burden in real time. We have developed a circulating tumor cells (CTCs) driven ML model as a predictor for the treatment decision strategy for both surgery and adjuvant therapy in head and neck squamous cell carcinoma (HNSCC) patients. Methods In this study, a total of 380 HNSCC patients who underwent either surgery alone or surgery plus adjuvant therapy were accounted for. CTCs in patients were stratified based on clinicopathological parameters and using the OncoDiscover platform having an anti-EpCAM antibody system regulated by the Drug Controller of India. Following this, we explored the predictive performance of the ML model on the usefulness of adjuvant therapy in HNSCC patients after the surgery. The available data was randomly divided into two subsets. First, 75% of the original data was applied for training the ML, and the rest 25% of the data was used as a test set. Survival curves were generated by the Kaplan–Meier method and calculated through the log-rank test. Results The XGBoost machine learning classifier was superior to Random Forest and SVM-based analyses in predicting the usefulness of adjuvant therapy post-surgery using CTCs alone or in combination with other clinical parameters in HNSCC patients. Machine learning algorithms were compared for predicting the accuracy of patient stratification. The results for each model were: XGBoost model (Accuracy = 0.84, ROC value = 0.73, Kappa = 0.43); Random Forest model (Accuracy = 0.81, ROC value = 0.70, Kappa = 0.41); SVM model (Accuracy = 0.76, ROC value = 0.69, Kappa = 0.40). The ROC value of the XGBoost model was highest (0.73), while the ROC value for the SVM model was lower (0.69). We observed that when CTCs were combined with clinicopathological parameters, the accuracy, kappa values, and AUC-ROC drastically improved in predicting the usefulness of adjuvant therapy post-surgery. A similar trend was observed when CTCs were combined with clinicopathological parameters in predicting the line of chemotherapy post-surgery. Conclusions ML-enabled, CTC-driven predictions can be highly accurate and ascertain the patient treatments. CTCs can be a positive predictor for selecting a patient’s treatment regimen in both surgery as well as in the type of treatment (e.g., surgery alone or surgery + adjuvant therapy). It can also be implicated to classify the patients and determine who necessitates additional adjuvant therapy. Further investigations in this direction are necessary to predict the treatment options based on ML that may improve the overall survival of cancer patients. 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

Combined ctDNA and CTC profiling correlates with PET-CT in cancer progression monitoring. Publications 25 November 2024 ISLB 2024: Comprehensive Analysis of ctDNA and CTCs Reveals Resistance signatures and Correlations with PET Scan Outcomes in Cancer Patients Integrated ctDNA and CTC analysis correlates with PET-CT outcomes to reveal treatment resistance and aggressive cancer progression. Introduction Liquid biopsy offers real-time insights into tumor dynamics. Circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) stand out as promising biomarkers due to their potential to provide comprehensive information about tumor evolution, treatment response, and the emergence of resistance. Concordance between ctDNA, CTCs, and PET-CT scans holds immense promise in cancer management, including identifying treatment resistance and correlating with PET scan outcomes. Methods Retrospectively, 18 patients with progressive and/or metastatic disease undergoing treatment were monitored. Paired samples for ctDNA and CTCs were evaluated. NGS libraries were prepared using a hybridization-capture method based on the custom-designed OncoIndx 1080 CGP panel and deep sequenced on the Illumina NextSeq 2000 in paired-end mode (150 × 2). Variant calling was performed using the proprietary bioinformatics pipeline iCare. CTCs were isolated using the OncoDiscover platform possessing an anti-EpCAM antibody-based immunomagnetic system from 1.5 ml of blood. CTCs were confirmed with CK18+, PD-L1+, DAPI+, and CD45– markers. Results ctDNA analysis showed that every patient (100%, n = 18) had at least one actionable genomic finding. Among them, 44.44% (n = 8) had concurrent mutations in the BRCA1/2 and TP53 genes, and 87.5% (n = 7) of these patients also possessed detectable CTCs. A smaller subset, 11.11% (n = 2), showed driver mutations in the EGFR gene. The remaining patients exhibited mutations in genes including KRAS, PTEN, STK11, RB1, AR, KIT, MET, and CDKN2A. These molecular profiles correlated with treatment resistance and were consistent with PET scan results showing disease progression in 88.88% (n = 16) of patients. Only 11.11% (n = 2) of the cohort demonstrated therapeutic response in recent PET scans. Notably, the combination of BRCA1/2 and TP53 mutations, along with the presence of CTCs, was primarily observed in patients with advanced or metastatic aggressive disease. These co-occurring mutations were identified in ovarian, biliary duct, and breast cancers. Conclusions The concurrent presence of BRCA1/2 and TP53 mutations alongside CTCs suggests aggressive disease progression and metastasis across the patient group. Moreover, the molecular interplay between BRCA1/2 and TP53 mutations has been associated with resistance to PARP inhibitors. These findings emphasize the urgent need for longitudinal monitoring in patients with both BRCA1/2 and TP53 mutations coupled with CTC detection. 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

Actorius Innovations at AACR 2026 Publications 22 April 2026 AACR 2026: Over expressing PD-L1 circulating tumor cells with clusters in prostate cancer patients Study shows high prevalence of PD-L1–positive circulating tumor cells in prostate cancer, highlighting their value for monitoring disease progression and immune evasion. Abstract Background Prostate cancer (PC) detection remains challenging due to the limited specificity and sensitivity of current screening methods, including PSA testing. PSA testing does not reliably distinguish aggressive disease from indolent forms, often leading to overdiagnosis and overtreatment. Circulating tumor cells (CTCs), however, offer greater clinical value by providing real-time insights into tumor biology, disease progression, and treatment response. Unlike PSA, CTCs represent a dynamic biomarker reflecting systemic minimal cellular residual disease (MCRD), which can support monitoring and guide personalized prostate cancer management. In addition, the overexpression of PD-L1 on CTCs provides insight into immune evasion mechanisms and may have predictive and prognostic value in prostate cancer. In this study, we report the capture of CTCs, including PD-L1–positive cells and CTC clusters, in prostate cancer patients. Methods A retrospective analysis was conducted on 239 prostate cancer patients to evaluate the presence of PD-L1–positive CTCs and CTC clusters. The cohort included 216 (90.4%) baseline samples and 23 (9.6%) follow-up samples. CTCs were isolated using the CDSCO-approved OncoDiscover Test (India), which employs anti-EpCAM antibody–based immunomagnetic enrichment from 1.5 mL of blood. CTCs were identified as CK18⁺/DAPI⁺/CD45⁻ cells with PD-L1 expression and distinct morphology. Automated fluorescence imaging was used to quantify signal intensities and correlate them with clinicopathological parameters. Patients were stratified by age, and quantitative analyses of CTC positivity, PD-L1 expression, and CTC cluster frequency were performed. Results CTCs were detected in 173 patients (72.4%), while 66 patients (27.6%) were CTC-negative. Among 157 evaluable samples for PD-L1 expression, 131 (54.8%) were PD-L1 positive and 26 (10.9%) were negative. CTC clusters were observed in 19 patients (11%), while 154 patients (89%) exhibited only single CTCs. At baseline, CTCs were detectable in 70.4% of patients, increasing to 91.3% in follow-up samples. PD-L1–positive CTCs were observed in 52.3% of patients at baseline and 85.7% at follow-up. Additionally, PD-L1–positive CTC clusters increased from 10.5% at baseline to 13.1% at follow-up. The predominant age groups were 61–70 years (39.0%) and 71–80 years (39.9%), together comprising nearly 80% of the cohort. The mean distribution of CTC counts per patient was 1.14 for total CTCs, 0.95 for PD-L1–positive CTCs, and 0.12 for CTC clusters. Conclusion A high prevalence of CTCs and PD-L1 expression was observed among prostate cancer patients, particularly in older age groups. The detection of PD-L1–positive CTCs highlights the presence of confirmatory MCRD and circulating disease. Although the incidence of CTC clusters was relatively low, their presence may indicate more aggressive disease phenotypes. 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