CTC & CSC cancer Tests

In order to evaluate the molecular biology of the tumor cell population, a  CTC (Circulating tumor cells) as well as a Cancer Stem Cells exam are important for both monitoring progress and determining prognosis. Yet, these tests are almost always missed by conventional oncologists.

By far, the most important test is this one because tumor circulatory stem cells can shed from a 2mm tumor and these are the cells that are the engins of metastases, from which most cancer patients die.

The best test on the market is the  Cell Search Circulating Tumor Cell (CTC) test. This test is a simple blood test.  Some conventional ontologists use this test  in assessing the prognosis of patients with metastatic breast, colorectal, or prostate cancer. But most integrative and holistic oncologists will use this test for many more cancers and indications.

The CellSearch System identifies and enumerates the number of circulating tumor cells (CTCs) in a blood specimen.(1) Studies suggest that the number of CTCs is associated with progression-free and overall survival in patients with metastatic colorectal cancer.(2,3)

Results are reported as favorable or unfavorable. In patients with metastatic colon cancer, the finding of > or =3 circulating tumor cells/7.5 mL of blood is predictive of shorter progression-free survival and overall survival.(2)

This test is FDA approved only for monitoring colon, prostate and breat cancer patients with metastatic disease. Blood specimens must be drawn into a CellSave tube and be processed in the laboratory within 96 hours of draw. (4)

This test does not provide information about the primary site of a tumor. It measures the risk as well as the  density  of metastases. The CellSearch test is the only FDA-approved test for CTC assessment. Each result of the CellSearch test is verified by both a cytotechnologist and a pathologist to ensure quality.

Currently, Medicare and some private insurers cover the CellSearch test, which costs about $350

Contents

References

 1. Allard WJ, Matera J, Miller MC, et al: Tumor cells circulate in the peripheral blood of all major carcinomas but not in healthy subjects or patients with nonmalignant diseases. Clin Cancer Res 2004 Oct;10:6897-6904
2. Cohen SJ, Punt CJ, Iannotti N, et al: Relationship of circulating tumor cells to tumor response, progression-free survival, and overall survival in patients with metastatic colorectal cancer. J Clin Oncol 2008 Jul;26(19):3213-3221
3. Cohen SJ, Punt CJ, Iannotti N, et al: Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer. Ann Oncol 2009;20(7):1223-1229
4 Patients on doxorubicin (Adriamvcin) must wait a minimum of 7 days after administration before blood can be drawn for this test.
For an understanding of circulatory Tumor and cancer stem cells, see this Source.
In the United States, the best place to order this test can be ordered at the Cell Search Link.  The  Mayo Clinic can also process these tests. (Source)

Screen Shot 2015-04-24 at 5.34.39 PM

Copyright (c) 2019: Advanced Cancer Research Institute, Pr Joubert and agents. All rights reserved. In terms of “fair use”,  the Institute allows the free use of this posted article provided it is not altered, full attribution is included as well as the Institute’s Post URL link. Furthermore, consistent with “fair use” case law,  small sections from the Institute’s posted article can be used as long as the above mentioned attributions are made and as long as the usage purpose is based on furthering education and science. For any other usage reason, written permission is required.
DISCLAIMER. Nothing in this blog-webstie is to be construed as medical or legal advise, including, but not limited to replies, comments and posts, all of which can not be deemed to constitute either a therapist-patient nor an attorney-client relationship.  For additional details about privacy policy & terms of use, please see the Institute’s legal link.

 

 

In order to evaluate the molecular biology of the tumor cell population, a  CTC (Circulating tumor cells) as well as a Cancer Stem Cells exam are important for both monitoring progress and determining prognosis. Yet, these tests are almost always missed by conventional oncologists.

By far, the most important test is this one because tumor circulatory stem cells can shed from a 2mm tumor and these are the cells that are the engins of metastases, from which most cancer patients die.

The best test on the market is the  Cell Search Circulating Tumor Cell (CTC) test. This test is a simple blood test.  Some conventional ontologists use this test  in assessing the prognosis of patients with metastatic breast, colorectal, or prostate cancer. But most integrative and holistic oncologists will use this test for many more cancers and indications.

The CellSearch System identifies and enumerates the number of circulating tumor cells (CTCs) in a blood specimen.(1) Studies suggest that the number of CTCs is associated with progression-free and overall survival in patients with metastatic colorectal cancer.(2,3)

Results are reported as favorable or unfavorable. In patients with metastatic colon cancer, the finding of > or =3 circulating tumor cells/7.5 mL of blood is predictive of shorter progression-free survival and overall survival.(2)

This test is FDA approved only for monitoring colon, prostate and breat cancer patients with metastatic disease. Blood specimens must be drawn into a CellSave tube and be processed in the laboratory within 96 hours of draw. (4)

This test does not provide information about the primary site of a tumor. It measures the risk as well as the  density  of metastases. The CellSearch test is the only FDA-approved test for CTC assessment. Each result of the CellSearch test is verified by both a cytotechnologist and a pathologist to ensure quality.

Currently, Medicare and some private insurers cover the CellSearch test, which costs about $350

References

 1. Allard WJ, Matera J, Miller MC, et al: Tumor cells circulate in the peripheral blood of all major carcinomas but not in healthy subjects or patients with nonmalignant diseases. Clin Cancer Res 2004 Oct;10:6897-6904
2. Cohen SJ, Punt CJ, Iannotti N, et al: Relationship of circulating tumor cells to tumor response, progression-free survival, and overall survival in patients with metastatic colorectal cancer. J Clin Oncol 2008 Jul;26(19):3213-3221
3. Cohen SJ, Punt CJ, Iannotti N, et al: Prognostic significance of circulating tumor cells in patients with metastatic colorectal cancer. Ann Oncol 2009;20(7):1223-1229
4 Patients on doxorubicin (Adriamvcin) must wait a minimum of 7 days after administration before blood can be drawn for this test.
For an understanding of circulatory Tumor and cancer stem cells, see this Source.
In the United States, the best place to order this test can be ordered at the Cell Search Link.  The  Mayo Clinic can also process these tests. (Source)

TO BE ADDED

https://www.nature.com/articles/s41467-019-09439-9

Article | OPEN | Published: 01 April 2019

A temporary indwelling intravascular aphaeretic system for in vivo enrichment of circulating tumor cells

  • Tae Hyun Kim, Yang Wang, C. Ryan Oliver, Douglas H. Thamm, Laura Cooling, Costanza Paoletti, Kaylee J. Smith, Sunitha Nagrath & Daniel F. Hayes

Nature Communications

volume

 10, Article number: 1478 (2019) | Download Citation

Abstract

Circulating tumor cells (CTCs) have become an established biomarker for prognosis in patients with various carcinomas. However, current ex vivo CTC isolation technologies rely on small blood volumes from a single venipuncture limiting the number of captured CTCs. This produces statistical variability and inaccurate reflection of tumor cell heterogeneity. Here, we describe an in vivo indwelling intravascular aphaeretic CTC isolation system to continuously collect CTCs directly from a peripheral vein. The system returns the remaining blood products after CTC enrichment, permitting interrogation of larger blood volumes than classic phlebotomy specimens over a prolonged period of time. The system is validated in canine models showing capability to screen 1–2% of the entire blood over 2 h. Our result shows substantial increase in CTC capture, compared with serial blood draws. This technology could potentially be used to analyze large number of CTCs to facilitate translation of analytical information into future clinical decisions.

Introduction

Cancer metastases arise from circulating tumor cells (CTCs) that are shed from the primary tumor and circulate through lymphatic channels and blood1.

Hanahan, D. & Weinberg, R. A. Hallmarks of cancer: the next generation. Cell 144, 646–674 (2011).

Although identified more than 150 years ago2, until recently, CTCs were difficult to detect, enumerate, and characterize.

Ashworth, T. R. A case of cancer in which cells similar to those in the tumours were seen in the blood after death. Australas. Med. J. 14, 146–149 (1869).

Using modern technologies, several studies have now demonstrated that elevated levels of CTC isolated from a single blood draw are prognostic in patients with metastatic breast, colorectal, prostate, and lung cancers, as well as early stage breast and prostate cancers3,4,5,6,7,8.

Furthermore, CTC analysis holds promise for predicting benefit from targeted therapies, pharmacodynamic monitoring during treatment, and insight into the biology of metastases9,10. Indeed, CTC evaluation might be used for early detection of malignancy, if an assay with sufficient sensitivity and specificity could be developed.

  • 2.
    Ashworth, T. R. A case of cancer in which cells similar to those in the tumours were seen in the blood after death. Australas. Med. J. 14, 146–149 (1869).

  • 3.
    Alix-Panabières, C. & Pantel, K. Circulating tumor cells: liquid biopsy of cancer. Clin. Chem. 59, 110–118 (2013).

  • 4.
    Cristofanilli, M. et al. Circulating tumor cells, disease progression, and survival in metastatic breast cancer. N. Engl. J. Med. 351, 781–791 (2004).

  • 5.
    Smerage, J. B. et al. Circulating tumor cells and response to chemotherapy in metastatic breast cancer: SWOG S0500. J. Clin. Oncol. 32, 3483–3489 (2014).

  • 6.
    Cohen, S. J. et al. Relationship of circulating tumor cells to tumor response, progression-free survival, and overall survival in patients with metastatic colorectal cancer. J. Clin. Oncol. 26, 3213–3221 (2008).

  • 7.
    de Bono, J. S. et al. Circulating tumor cells predict survival benefit from treatment in metastatic castration-resistant prostate cancer. Clin. Cancer Res. 14, 6302–6309 (2008).

  • 8.
    Krebs, M. G. et al. Evaluation and prognostic significance of circulating tumor cells in patients with non-small-cell lung cancer. J. Clin. Oncol. 29, 1556–1563 (2011).

  • 9.
    Alix-Panabieres, C. & Pantel, K. Clinical applications of circulating tumor cells and circulating tumor dna as liquid biopsy. Cancer Discov. 6, 479–491 (2016).

  • 10.
    Paoletti, C. & Hayes, D. F. Circulating tumor cells. Adv. Exp. Med. Biol. 882, 235–258 (2016).

    • Show context for reference 10

Screen Shot 2015-04-24 at 5.34.39 PM

Copyright (c) 2019: Advanced Cancer Research Institute, Pr Joubert and agents. All rights reserved. In terms of “fair use”,  the Institute allows the free use of this posted article provided it is not altered, full attribution is included as well as the Institute’s Post URL link. Furthermore, consistent with “fair use” case law,  small sections from the Institute’s posted article can be used as long as the above mentioned attributions are made and as long as the usage purpose is based on furthering education and science. For any other usage reason, written permission is required.
DISCLAIMER. Nothing in this blog-webstie is to be construed as medical or legal advise, including, but not limited to replies, comments and posts, all of which can not be deemed to constitute either a therapist-patient nor an attorney-client relationship.  For additional details about privacy policy & terms of use, please see the Institute’s legal link.

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