CTCs as Liquid Biopsy: Where Are We Now?

A few years ago, the analysis of circulating tumor cells (CTCs) in the blood of patients with cancer was defined by the term “real-time liquid biopsy.” Blood samples can be obtained and analyzed at the time of diagnosis and repeatedly during the systemic treatment. The analysis of the liquid biopsy has provided new insights into the biology of metastasis with important implications for the clinical management of cancer patients. In this review, we updated all technical strategies developed to improve enrichment, detection, and characterization of CTCs. We also focused on their biological properties as well as on their clinical relevance in different cancer types. At the end, we opened the discussion to all the other circulating biomarkers used as liquid biopsy

Mass Spectrometry as a Highly Sensitive Method for Specific Circulating Tumor DNA Analysis in NSCLC:A Comparison Study

Simple Summary We compared the UltraSEEK (TM) Lung Panel on the MassARRAY (R) System (Agena Bioscience) with the FDA-approved Cobas (R) EGFR Mutation Test v2 for the detection of EGFR mutations in liquid biopsies of NSCLC patients, accompanied with preanalytical sample assessment using the novel Liquid IQ (R) Panel. For the detection of relevant predictive mutations using the UltraSEEK (TM) Lung Panel, an input of over 10 ng showed 100% concordance with Cobas (R) EGFR Mutation Test v2 and detection of all tissue confirmed mutations. In case of lower ccfDNA input, the risk of missing clinically relevant mutations should be considered. The use of a preanalytical ccfDNA quality control assay such as the Liquid IQ (R) Panel is recommended to confidently interpret results, avoiding bias induced by non-specific genomic DNA and low input of specific tumoral ccfDNA fragments. Plasma-based tumor mutational profiling is arising as a reliable approach to detect primary and therapy-induced resistance mutations required for accurate treatment decision making. Here, we compared the FDA-approved Cobas (R) EGFR Mutation Test v2 with the UltraSEEK (TM) Lung Panel on the MassARRAY (R) System on detection of EGFR mutations, accompanied with preanalytical sample assessment using the novel Liquid IQ (R) Panel. 137 cancer patient-derived cell-free plasma samples were analyzed with the Cobas (R) and UltraSEEK (TM) tests. Liquid IQ (R) analysis was initially validated (n = 84) and used to determine ccfDNA input for all samples. Subsequently, Liquid IQ (R) results were applied to harmonize ccfDNA input for the Cobas (R) and UltraSEEK (TM) tests for 63 NSCLC patients. The overall concordance between the Cobas (R) and UltraSEEK (TM) tests was 86%. The Cobas (R) test detected more EGFR exon19 deletions and L858R mutations, while the UltraSEEK (TM) test detected more T790M mutations. A 100% concordance in both the clinical (n = 137) and harmonized (n = 63) cohorts was observed when >10 ng of ccfDNA was used as determined by the Liquid IQ (R) Panel. The Cobas (R) and UltraSEEK (TM) tests showed similar sensitivity in EGFR mutation detection, particularly when ccfDNA input was sufficient. It is recommended to preanalytically determine the ccfDNA concentration accurately to ensure sufficient input for reliable interpretation and treatment decision making

Clouds across the new dawn for clinical, diagnostic and biological data : accelerating the development, delivery and uptake of personalized medicine

This research was funded by Reducing Disparities Across the European Union (BEACON) Project Number: 101080005.Peer reviewe

miRNA-30 family members inhibit breast cancer invasion, osteomimicry, and bone destruction by directly targeting multiple bone metastasis–associated genes

miRNAs are master regulators of gene expression that play key roles in cancer metastasis. During bone metastasis, metastatic tumor cells must rewire their biology and express genes that are normally expressed by bone cells (a process called osteomimicry), which endow tumor cells with full competence for outgrowth in the bone marrow. Here, we establish miR-30 family members miR-30a, miR-30b, miR-30c, miR-30d, and miR-30e as suppressors of breast cancer bone metastasis that regulate multiple pathways, including osteomimicry. Low expression of miR-30 in primary tumors from patients with breast cancer were associated with poor relapse-free survival. In addition, estrogen receptor (ER)-negative/progesterone receptor (PR)-negative breast cancer cells expressed lower miR-30 levels than their ER/PR-positive counterparts. Overexpression of miR-30 in ER/PR-negative breast cancer cells resulted in the reduction of bone metastasis burden in vivo. In vitro, miR-30 did not affect tumor cell proliferation, but did inhibit tumor cell invasion. Furthermore, overexpression of miR-30 restored bone homeostasis by reversing the effects of tumor cell–conditioned medium on osteoclastogenesis and osteoblastogenesis. A number of genes associated with osteoclastogenesis stimulation (IL8, IL11), osteoblastogenesis inhibition (DKK-1), tumor cell osteomimicry (RUNX2, CDH11), and invasiveness (CTGF, ITGA5, ITGB3) were identified as targets for repression by miR-30. Among these genes, silencing CDH11 or ITGA5 in ER-/PR-negative breast cancer cells recapitulated inhibitory effects of miR-30 on skeletal tumor burden in vivo. Overall, our findings provide evidence that miR-30 family members employ multiple mechanisms to impede breast cancer bone metastasis and may represent attractive targets for therapeutic intervention. Significance: These findings suggest miR-30 family members may serve as an effective means to therapeutically attenuate metastasis in triple-negative breast cancer

Clinical relevance and biology of circulating tumor cells

Most breast cancer patients die due to metastases, and the early onset of this multistep process is usually missed by current tumor staging modalities. Therefore, ultrasensitive techniques have been developed to enable the enrichment, detection, isolation and characterization of disseminated tumor cells in bone marrow and circulating tumor cells in the peripheral blood of cancer patients. There is increasing evidence that the presence of these cells is associated with an unfavorable prognosis related to metastatic progression in the bone and other organs. This review focuses on investigations regarding the biology and clinical relevance of circulating tumor cells in breast cancer

“Circulating Tumor Cells: Finding Rare Events for a Huge Knowledge of Cancer Dissemination”

Circulating tumor cells (CTCs) as real-time liquid biopsy [...

Abstracts from the 11th International Symposium on Minimal Residual Disease, 3-5 May 2018, Montpellier, France

International audienc

Crucial roles of circulating tumor cells in the metastatic cascade and tumor immune escape: biology and clinical translation

International audienceCancer-related deaths are mainly caused by metastatic spread of tumor cells from the primary lesion to distant sites via the blood circulation. Understanding the mechanisms of blood-borne tumor cell dissemination by the detection and molecular characterization of circulating tumor cells (CTCs) in the blood of patients with cancer has opened a new avenue in cancer research. Recent technical advances have enabled a comprehensive analysis of the CTCs at the genome, transcriptome and protein level as well as first functional studies using patient-derived CTC cell lines. In this review, we describe and discuss how research on CTCs has yielded important insights into the biology of cancer metastasis and the response of patients with cancer to therapies directed against metastatic cells. Future investigations will show whether CTCs leaving their primary site are more vulnerable to attacks by immune effector cells and whether cancer cell dissemination might be the 'Achilles heel' of metastatic progression. Here, we focus on the lessons learned from CTC research on the biology of cancer metastasis in patients with particular emphasis on the interactions of CTCs with the immune system. Moreover, we describe and discuss briefly the potential and challenges for implementing CTCs into clinical decision-making including detection of minimal residual disease, monitoring efficacies of systemic therapies and identification of therapeutic targets and resistance mechanisms

Clinical Applications of Circulating Tumor Cells and Circulating Tumor DNA as Liquid Biopsy

International audience"Liquid biopsy" focusing on the analysis of circulating tumor cells (CTC) and circulating cell-free tumor DNA (ctDNA) in the blood of patients with cancer has received enormous attention because of its obvious clinical implications for personalized medicine. Analyses of CTCs and ctDNA have paved new diagnostic avenues and are, to date, the cornerstones of liquid biopsy diagnostics. The present review focuses on key areas of clinical applications of CTCs and ctDNA, including detection of cancer, prediction of prognosis in patients with curable disease, monitoring systemic therapies, and stratification of patients based on the detection of therapeutic targets or resistance mechanisms.SIGNIFICANCE:The application of CTCs and ctDNA for the early detection of cancer is of high public interest, but it faces serious challenges regarding specificity and sensitivity of the current assays. Prediction of prognosis in patients with curable disease can already be achieved in several tumor entities, particularly in breast cancer. Monitoring the success or failure of systemic therapies (i.e., chemotherapy, hormonal therapy, or other targeted therapies) by sequential measurements of CTCs or ctDNA is also feasible. Interventional studies on treatment stratification based on the analysis of CTCs and ctDNA are needed to implement liquid biopsy into personalized medicine. Cancer Discov; 6(5); 479-91. ©2016 AACR