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      A microfluidic device for label-free, physical capture of circulating tumor cell-clusters

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          Abstract

          Cancer cells metastasize through the bloodstream either as single migratory circulating tumor cells (CTCs) or as multicellular groupings (CTC-clusters). Existing technologies for CTC enrichment are designed primarily to isolate single CTCs, and while CTC-clusters are detectable in some cases, their true prevalence and significance remain to be determined. Here, we developed a microchip technology (Cluster-Chip) specifically designed to capture CTC-clusters independent of tumor-specific markers from unprocessed blood. CTC-clusters are isolated through specialized bifurcating traps under low shear-stress conditions that preserve their integrity and even two-cell clusters are captured efficiently. Using the Cluster-Chip, we identify CTC-clusters in 30–40% of patients with metastatic cancers of the breast, prostate and melanoma. RNA sequencing of CTC-clusters confirms their tumor origin and identifies leukocytes within the clusters as tissue-derived macrophages. Together, the development of a device for efficient capture of CTC-clusters will enable detailed characterization of their biological properties and role in cancer metastasis.

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          Most cited references27

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          The blockade of immune checkpoints in cancer immunotherapy.

          Among the most promising approaches to activating therapeutic antitumour immunity is the blockade of immune checkpoints. Immune checkpoints refer to a plethora of inhibitory pathways hardwired into the immune system that are crucial for maintaining self-tolerance and modulating the duration and amplitude of physiological immune responses in peripheral tissues in order to minimize collateral tissue damage. It is now clear that tumours co-opt certain immune-checkpoint pathways as a major mechanism of immune resistance, particularly against T cells that are specific for tumour antigens. Because many of the immune checkpoints are initiated by ligand-receptor interactions, they can be readily blocked by antibodies or modulated by recombinant forms of ligands or receptors. Cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) antibodies were the first of this class of immunotherapeutics to achieve US Food and Drug Administration (FDA) approval. Preliminary clinical findings with blockers of additional immune-checkpoint proteins, such as programmed cell death protein 1 (PD1), indicate broad and diverse opportunities to enhance antitumour immunity with the potential to produce durable clinical responses.
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            Detection, clinical relevance and specific biological properties of disseminating tumour cells.

            Most cancer deaths are caused by haematogenous metastatic spread and subsequent growth of tumour cells at distant organs. Disseminating tumour cells present in the peripheral blood and bone marrow can now be detected and characterized at the single-cell level. These cells are highly relevant to the study of the biology of early metastatic spread and provide a diagnostic source in patients with overt metastases. Here we review the evidence that disseminating tumour cells have a variety of uses for understanding tumour biology and improving cancer treatment.
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              Is Open Access

              Isolation and retrieval of circulating tumor cells using centrifugal forces

              Presence and frequency of rare circulating tumor cells (CTCs) in bloodstreams of cancer patients are pivotal to early cancer detection and treatment monitoring. Here, we use a spiral microchannel with inherent centrifugal forces for continuous, size-based separation of CTCs from blood (Dean Flow Fractionation (DFF)) which facilitates easy coupling with conventional downstream biological assays. Device performance was optimized using cancer cell lines (> 85% recovery), followed by clinical validation with positive CTCs enumeration in all samples from patients with metastatic lung cancer (n = 20; 5–88 CTCs per mL). The presence of CD133+ cells, a phenotypic marker characteristic of stem-like behavior in lung cancer cells was also identified in the isolated subpopulation of CTCs. The spiral biochip identifies and addresses key challenges of the next generation CTCs isolation assay including antibody independent isolation, high sensitivity and throughput (3 mL/hr); and single-step retrieval of viable CTCs.
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                Author and article information

                Journal
                101215604
                32338
                Nat Methods
                Nat. Methods
                Nature methods
                1548-7091
                1548-7105
                28 April 2015
                18 May 2015
                July 2015
                01 January 2016
                : 12
                : 7
                : 685-691
                Affiliations
                [1 ]Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
                [2 ]Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
                [3 ]Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
                [4 ]Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
                [5 ]Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
                [6 ]Howard Hughes Medical Institute, Chevy Chase, MD, USA
                Author notes
                Correspondence should be addressed to M.T. ( mtoner@ 123456mgh.harvard.edu )
                [7]

                Present address: School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA

                [8]

                These authors contributed equally to this work.

                Article
                NIHMS684496
                10.1038/nmeth.3404
                4490017
                25984697
                a5e56851-af45-4c71-a9ba-fdcf84d37dff
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                Life sciences
                Life sciences

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