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Related Experiment Video

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Adaptation of Semiautomated Circulating Tumor Cell CTC Assays for Clinical and Preclinical Research Applications
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Circulating Tumor Cells as Potential Biomarkers in Bladder Cancer.

Ajjai Alva1, Terence Friedlander2, Melanie Clark1

  • 1Division of Hematology and Oncology, Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan.

The Journal of Urology
|April 28, 2015
PubMed
Summary
This summary is machine-generated.

This study shows circulating tumor cells (CTCs) can help manage bladder cancer. The IsoFlux method is more sensitive than CellSearch for detecting CTCs and their mutations.

Keywords:
circulatinggenomicsmolecularneoadjuvant therapyneoplastic cellspathologyurinary bladder neoplasms

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Area of Science:

  • Oncology
  • Molecular Diagnostics
  • Urology

Background:

  • Bladder cancer management relies on accurate staging and monitoring.
  • Circulating tumor cells (CTCs) offer a minimally invasive approach for cancer assessment.
  • Neoadjuvant chemotherapy is a standard treatment for muscle-invasive bladder cancer.

Purpose of the Study:

  • To evaluate the diagnostic utility of circulating tumor cells (CTCs) in neoadjuvant bladder cancer.
  • To compare the sensitivity of the IsoFlux system with CellSearch for CTC enumeration.
  • To assess the feasibility of using next-generation sequencing (NGS) on CTCs for mutational analysis.

Main Methods:

  • Enrolled 20 patients with bladder cancer receiving neoadjuvant chemotherapy.
  • Collected blood samples at baseline and after one chemotherapy cycle.
  • Enriched CTCs using the IsoFlux system and performed enumeration and NGS analysis.
  • Compared IsoFlux results with CellSearch and correlated CTC levels with pathological outcomes.

Main Results:

  • Median CTC counts differed between neoadjuvant (13 baseline, 5 followup), metastatic (29), and healthy (2) groups.
  • IsoFlux detected CTCs in 44% of samples, while CellSearch detected none.
  • High CTC levels at baseline and followup correlated with unfavorable pathological stage disease (T1-T4 or N+).
  • NGS detected somatic variants in 4 of 8 patients, all with high CTC fraction (>5% purity).

Conclusions:

  • CTC assays show potential in managing bladder cancer patients.
  • The IsoFlux method demonstrates superior sensitivity for CTC detection compared to CellSearch.
  • NGS analysis of CTCs is sensitive enough to detect clinically relevant genomic alterations.