Poster Presentation 27th Lorne Cancer Conference 2015

The utility of circulating tumor cells and DNA in cancer therapy (#119)

Therese M Becker 1 2 3 , Kevin J Spring 1 2 , Scott MacKenzie 2 4 , Majid Ebrahimi Warkiani 5 , Yafeng Ma 1 3 , Stephanie H Lim 1 3 , Joseph Po 1 2 , Paul de Souza 1 2 3 4
  1. Ingham Institute, Liverpool, NSW, Australia
  2. School of Medicine, University of Western Sydney, Capbelltown, NSW, Australia
  3. South Western Clinical School, University of New South Wales, Liverpool, NSW, Australia
  4. Department of Medical Oncology, Liverpool Hospital, Liverpool, NSW, Australia
  5. School of Mechanical and Manufacturing Engineering, University of New South Wales, Kensington, NSW, Australia

Circulating tumour cells (CTCs) and DNA (ctDNA) have enormous translational potential to alter the clinical management of cancer treatment. We recently established a CTC facility focused on blood-based assays for the analysis of cancer-associated biomarkers. Our research interest is on the development and application of CTCs and ctDNA based assays that can be translated into the clinical setting to improve chemotherapeutic monitoring and patient management, with the ultimate goal of enhancing patient outcomes.

Here we provide insights into some of our CTC and ctDNA based research approaches including: (i) Monitoring CTCs and ctDNA as an early marker of tumor progression before it is measurable using current imaging modalities. We are tracking newly diagnosed advanced prostate cancer patients that show treatment response by a reduction in CTCs as measured by immunomagnetic CTC capture using the IsoFlux platform. (ii) Serial blood sampling to assess transient increases in CTCs during surgery to determine if CTCs can be used as a tool to monitor and compare surgical procedures as a “quality control” and thus guide improvements to surgical praxis to minimise surgically associated release of CTCs with metastatic potential. (iii) Optimisation of strategies to immunomagnetically capture melanoma CTCs (which do not express EpCAM) by targeting MCAM and HMW-MAA and using a melanoma specific antibody cocktail for CTC identification. (iv) The isolation of ovarian cancer CTCs that have undergone epithelial to mesenchymal transition to study the correlation of these cells to treatment response by identification of a set of candidate antibodies to improve ovarian CTC capture, and (v) utilization of a hybrid system by combining IsoFlux (immunomagnetic CTC sorter) and spiral microfluidic (size-based, label-free CTC sorter) platforms for efficient recovery of heterogeneous CTCs.

In summary, the application of CTC and ctDNA analysis will likely change therapeutic approaches to cancer management in the future.