Circulating Tumor Cell Kinetics and Morphology from the Liquid Biopsy Predict Disease Progression in Patients with Metastatic Colorectal Cancer Following Resection

The liquid biopsy has the potential to improve current clinical practice in oncology byproviding real-time personalized information about a patient’s disease status and response to treatment. In this study, we evaluated 161 peripheral blood (PB) samples that were collected aroundsurgical resection from 47 metastatic colorectal cancer (mCRC) patients using the High-DefinitionSingle Cell Assay (HDSCA) workflow. In conjunction with the standard circulating tumor cell (CTC)enumeration, cellular morphology and kinetics between time-points of collection were considered inthe survival analysis. CTCs, CTC-Apoptotic, and CTC clusters were found to indicate poor survivalwith an increase in cell count from pre-resection to post-resection. This study demonstrates thatCTC subcategorization based on morphological differences leads to nuanced results between thesubtypes, emphasizing the heterogeneity within the CTC classification. Furthermore, we show thatfactoring in the time-point of each blood collection is critical, both for its static enumeration and forthe change in cell populations between draws. By integrating morphology and time-based analysisalongside standard CTC enumeration, liquid biopsy platforms can provide greater insight into thepathophysiology of mCRC by highlighting the complexity of the disease across a patient’s treatment