Label-free, high-throughput method for CTC isolation directly from whole blood

Workflow, mechanism, and performance of FAST disc

Various circulating biomarkers, circulating tumor cells (CTCs) offer a unique opportunity to obtain information on live tumor cells at the DNA, RNA, and protein levels. Conventional tissue biopsy is invasive, and therefore, more facile and less invasive liquid biopsy methods, able to monitor the disease response to targeted therapy and track the emergence of drug resistance, could significantly aid in the clinical management of the disease. Despite significant challenges associated with the extremely rare and heterogeneous characteristics of CTCs, recent technological advancements have allowed studying the prognostic value of CTCs, as well as monitoring and predicting the efficacy of therapy. Although much progress has been made and clinical significance of CTCs has been demonstrated, the remaining challenges include a high cost, low throughput, and complexity of the process, as well as false-positive/false-negative results, which hinder a wider adoption of CTC-based liquid biopsy as a routine practice in clinical settings. Prof. Cho and Prof Kim from Pusan University studied about potential of a CTC-based liquid biopsy for assessing the efficacy of therapy.

This report presented the preclinical validation of a fluid-assisted separation technology (FAST) disc, which allows rapid (>3 mL/min), reproducible, and label-free isolation of CTCs directly from unprocessed whole blood of patients with NSCLC. There was a serial monitoring of CTC counts, mutation detection, and single-cell multiplex gene expression of CTCs from a prospective cohort of patients with NSCLC receiving EGFR-TKIs treatment. The study highlights the potential of a CTC-based liquid biopsy for assessing the efficacy of therapy and emergent drug resistance

The study has been supported through the Korean Health Technology R&D Project of the Ministry of Health & Welfare and the IBS Center for Soft and Living Matter.

This work is detailed in a paper published in the Theranostics and highlighted on the front cover (Minji Lim et al., A lab-on-a-disc platform enables serial monitoring of individual CTCs associated with tumor progression during EGFR-targeted therapy for patients with NSCLC, Theranostics, DOI: 10.7150/thno.44693