Circulating Tumor Cells: Detection, Biology and Clinical Applications
- Understand the concept of liquid biopsy in cancer diagnostics
- Know the potential and challenges of liquid biopsy technologies
- Understand the principal biology behind liquid biopsy analyses
- Know the current and potential future applications of liquid biopsy in oncology
- Basic researchers (PhDs and Master Students) interested in cancer research with a focus on metastasis
- Clinical scientists involved in treating patients with solid tumors such as breast or prostate cancer
- Representatives of pharma companies involved in developing new cancer drugs for prevention of metastasis
Over the past 10 years, large-scale clinical studies have focused on the use of CTC counts as predictors of prognosis and response to therapy in particular in breast and prostate cancer. Although the capture of CTCs from whole blood is more cumbersome than the isolation of cell-free DNA in plasma samples, CTCs offer the opportunity to obtain information at the DNA, RNA and protein level. Moreover, proof-of-principle studies have shown that functional in vitro and in vivo analyses are possible.
Recently, circulating cfDNA has been shown promising results as marker for tumor-associated genomic aberrations. Cancer patients have much higher levels of normal circulating cfDNA than healthy individuals. When tumours increase in volume so too does the cellular turnover and hence the number of apoptotic and necrotic cells. Most cfDNA fragments measure between 180-200bp, suggesting that apoptosis likely produces the majority of cfDNA in the circulation.
Liquid biopsies are rapidly being integrated in the clinical management of cancer patients, yet the exact nature and origin of CTCs and cfDNA remain to be clarified.
Dr. Klaus Pantel, MD. PhD., is Full Professor of Medicine and Chairman of the Institute of Tumour Biology at the University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. The institute is part of the University Cancer Centre Hamburg (UCCH). The pioneer work of Dr. Pantel in the field of cancer micro-metastasis and circulating tumour cells (“liquid biopsy”) is reflected by more than 400 publications in excellent high ranking biomedical and scientific journals (incl. NEJM, Lancet, Nature Journals, PNAS, JCO, JNCI, Cancer Res., h-index: 88) and has been awarded recently (AACR Outstanding Investigator Award 2010, German Cancer Award 2010, ERC Advanced Investigator Grant 2011). Prof. Pantel is in the Editorial Board of international cancer journals (e.g., Cancer Res., Clin. Cancer Res.) and lead-PI of several European Reseach networks focusing on cancer metastasis and liquid biopsy analysis. Currently Dr. Pantel is the Scientific coordinator of the Cancer-ID consortium, a large EU-funded innovative medicines initiative with 38 partner institutions, which aims at clinical validation of blood-based biomarkers intended to be used as companion diagnostic in cancer therapy (http://www.cancer-id.eu/).
The inherent molecular heterogeneity of metastatic tumors and the ability of cancer genomes to dynamically evolve are not properly captured by surgical or bioptic specimens. The analysis of circulating tumor cells (CTCs) and cell free DNA (cfDNA) released from primary and metastatic lesions has the potential to change clinical practice by exploiting blood rather than tissue as a primary source of information. In addition, circulating cell-free miRNAs, microvesicles (e.g., exosomes) and tumor-educated platelets provide also tumor-associated information through “liquid biopsy” - a term introduced by Klaus Pantel and Catherine Alix-Panabieres in 8 years ago. Current ctDNA and CTC liquid biopsy analyses are already used to monitor disease response and track the emergence of drug resistance in cancer patients with advanced disease. Studies to assess how blood-based molecular profiles can be used for screening purposes (early detection) and monitoring of minimal residual disease are underway. In the present webinar open questions in this fast-evolving field of research we will be addressed with a focus on CTCs and ctDNA in the blood of patients with solid malignancies such as breast, lung, colon and prostate cancer.
- Speaker: KLAUS PANTEL
- Webinar Code: KLAU-0001