1. Isolation of Rare Circulating Tumor Cells in Cancer Patients by Microchip Technology Toner, et al. 2007
Stephanie Bachar
Matt Luchette

2. Background: Circulating Tumor Cells
CTCs: tumor cells shed into the blood stream
Motivation for detection
Study biology of metastasis
Diagnose, detect, monitor cancer in patients without invasive biopsy
The bone marrow niche: habitat to hematopoietic and mesenchymal stem cells, and unwitting host to molecular parasites
Y Shiozawa, A M Havens, K J Pienta and R S Taichman

3. Motivation for the “CTC-Chip”
Shortcomings prior to “CTC-Chip”
Accuracy: 20-60%
Purity: 0.1%
Non-viable cells
Photoacoustic detection of CTCs. Viator lab at University of Missouri

4. How to use the “CTC Chip" Flow sample through CTC Chip
EpCAM coated microposts
Verify with markers
Pressure Control
Blood on Rocker
CTC Chip
Toner 2007
EpCAM
Non-CTCs
CTCs
Micropost
CD45
Cytokeratin

5. Instrument Design: in silico
Maximize CTCs detected
Flow Velocity
Shear Force
Vary micropost characteristics
Theoretical capture efficiency of 65%
Toner 2007

6. Capture purity per type of cancer
Laboratory Results
1 target cell/10^9 blood cells
Purity of capture ~60% (competitors = 0.1%)
 Efficiency of capture ~65% (competitors = 35%)
Captured cells were viable and could be further manipulated
Capture purity per type of cancer
Toner 2007

7. Clinical Results
Identified CTCs in 99% cancer pts (competitors =  20-60%)
no false positives
Change in number of CTCs correlated with clinical path
No pre-processing required
Change in CTCs captured per mL (red) with lung cancer patient mirrors change in tumor size (blue)
Toner 2007

8. Concerns and next steps
How cells used afterwards?
How to mass produce chips?
Financially viable?
How reliable is EpCAM as a caner cell marker?
FDA approval
Paper tree-branch glucose and protein assay for urine
technologyreview.com

9. Recap/Applications
New diagnostic and prognostic tool for cancer patients
Provide alternative to biopsies for areas with low resources
Use to isolate and further study CTCs
MRI of 67-year old patient with pancreatic cancer with the pancreatic tumor indicated
imagingeconomics.com

10. Works Cited --imagingeconomics.com --technologyreview.com--
--The bone marrow niche: habitat to hematopoietic and mesenchymal stem cells, and unwitting host to molecular parasites Y Shiozawa, A M Havens, K J Pienta and R S Taichman