CONFERENCE SERIES: Biomarkers & Diagnostics
Recorded at: Next Generation Dx Summit
Digital Course: Circulating Tumor Cells As Surrogate Endpoints In Clinical Trials
Agenda At A Glance:
Clinical Significance of Disseminated and Circulating Tumor Cells
Circulating Tumor Cells as Biomarkers in Castration-Resistant Prostate Cancer
Recent trials using an FDA-cleared assay show that CTC number is a biomarker of prognosis and more predictive than posttherapy changes in PSA, raising the possibility that posttherapy changes in CTCs might represent an intermediate endpoint of treatment efficacy. The question of whether CTC counts are potential surrogates for survival is currently being addressed in the context of a phase 3 registration trial. Also under study are biologic profi ling of these tumors to explore the relationship between specific alterations in androgen receptor signaling and the response to novel agents targeting these alterations.
Circulating Tumor Cells in Epithelial Mesenchymal Transition and Disseminated Disease
The presence of circulating tumor cells (CTCs) in peripheral blood of patients with advanced breast cancer has prognostic value and predicts treatment better than radiological imaging and functional PET/CT. Current methods for detecting CTCs are based on the detection of non-leukocytes (CD45-) cells that express EpCAM; however, these methods are incapable of detecting CTCs that lose expression of EpCAM and undergo epithelial-mesenchymal transition (EMT) prior to entering the circulation. EMT is an embryonic program which has been implicated in breast cancer cell dissemination and endowing cancer cells with stem-like properties. Thus, CTC undergoing EMT may escape detection by conventional detection methods and that EMT genes may be involved in their dissemination in a fraction of patients with early or advanced breast cancer.
Micrometastases and Cancer Stem Cells: on Lethal Seeds and Supportive Soil
This talk will address the correlation of micrometastases and cancer stem cells and development of needed novel protocols for detection and characterization of DTC/CTC. The first clinical evidence on association of disseminated tumor cells with the putative breast cancer stem cell phenotype was published in Clin Can Res Okt 2006. Based on this data, novel protocols have been evaluated and established to enhance the sensitivity for DTC detection and enable the characterization of these cells according to the phenotype. In addition, the talk will provide the review of the current and important literature on interaction of DTC/CTC with the host (incl. bone and immune system).
Henry K. Lin, Ph.D., Wigner Fellow, Biosciences Division, Oak Ridge National Liboratory
Howard I. Scher, M.D., D. Wayne Calloway Chair in Urologic Oncology, Chief, Genitourinary Oncology Service, Department of Medicine, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center
James M. Reuben, Ph.D., Associate Professor, Hematopathology, M.D. Anderson Cancer Center
Marija Balić, Ph.D., Division of Oncology, Department of Internal Medicine, Medical University of Graz
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