from Flow Cytometry to Cytomics

The detection of circulating tumor cells (CTCs), an approach considered to be “liquid biopsy”, is crucial in cancer diagnosis, monitoring and prognosis. However, the extremely large number of blood cells challenges the rare CTC isolation and enrichment.

University researchers develop microfluidic device that partitions cancer cells according to size in effort to create a useful liquid biopsy method.

A circulating cancer cell (pink) attaches to carbon nanotube surface; white blood cells (blue) do not adhere and are later washed away.Using the tendency of circulating cancer cells to adhere to c…...

Clin Exp Med. 2019 Jun 12. doi: 10.1007/s10238-019-00563-w.[Epub ahead of print] Review...

Advancing technology is allowing scientists increasingly to search for tiny signs of cancer and other health issues in samples of patients' blood and urine. These "liquid biopsies" are less invasive than a traditional biopsy, and can provide information about what's happening...

In human breast cancer, both circulating tumour cells (CTCs) in peripheral blood and disseminated tumour cells (DTCs) in the bone marrow are predictive of short survival and may be used as liquid biopsy to guide therapy.

Cancer originates from small mistakes in our DNA. These mistakes are different for every person and dictate how aggressive their cancer is.On top of this, starting in development and continuing throughout life, new mistakes in our DNA can be …...

Room for improvement exists regarding recommendations for screening, staging, therapy selection, and frequency of surveillance of gastrointestinal cancers. Screening is costly and invasive, improved staging demands increased sensitivity and specificity to better guide therapy selection.

Dr. David Wong, associate dean for research, and his team received regulatory approval on their EFIRM (electric field-induced release and measurement) technology as a Clinical Laboratory Improvement Amendments (CLIA)-certified, College of American Pathology (CAP)-accredited assay to be used in clinical practice. EFIRM creates a reliable, novel, and impactful method to detect tumor-causing, lung cancer mutations in saliva and blood that is non-invasive, cost-effective, and quick. For the past four years until now, the technology has been in research and testing phases. Small celebration after the technology received its regulatory approval. Left to right: Drs. David Wong, Charles Strom, Michael Tu, Paul Krebsbach (Dean), Richard Bender, and Josh Deignan. A major contributor to helping move the EFIRM testing phase along is the National Cancer Institute (NCI), who awarded Dr. Wong and his collaborators, Drs. Wayne Grody and Josh Deignan with the UCLA Department of Pathology and Laboratory Medicine and Drs. Fang Wei, Charles Strom and Michael Tu of the School of Dentistry, $2.5M in 2017. The grant’s support successfully paid off, as the technology is now approved to be used in medical offices to assist a doctor’s diagnosis of a major disease—lung cancer. The goal is to use results from EFIRM, based on a patient’s saliva sample, to adjust therapeutic strategies in real-time, improving clinical outcomes. Another grant from by the National Cancer Institute, awarded in October 2018 for $5M over five years, is continuing to develop and refine the technology for early assessment of cancer. Dr. Wong’s lab is working with Dr. Denise Aberle, professor of radiology at the David Geffen School of Medicine at UCLA, Dr. Steven Dubinett, co-investigator and chief of pulmonary and critical care medicine in the Geffen School, and We Liao, co-inventor of the technology, to test the blood and saliva of at least 300 at-risk patients for lung cancer. Dr. Wong’s team has shown that the technology can detect early-stage lung cancer with greater than 90 percent similarity with traditional tissue biopsies.  In another defining moment for liquid biopsy and salivary diagnostics, Dr. Wong was invited to speak on the EFIRM Liquid Biopsy technology in an NCI-sponsored session at the annual meeting for the American Association for Cancer Research (AACR) in Atlanta, Georgia on April 2. In front of hundreds of cancer researchers from around the world, Wong was included in a session on the topic; “Liquid Biopsy: The Holy Grail for Early Cancer Detection.” Dr. Wong also chairs the Steering Committee of the NCI Liquid Biopsy consortium. Research panel at AACR, from left to right: Drs. Sudhir Srivastava (Chief NCI, Early Detection Research Network (EDRN), Lynn Sorbara (NCI Program Director), David Wong (UCLA), Bob Carter (Harvard/MGH), Changhuei Yang (CALTech), Nicholas Papadopoulos (Johns Hopkins). "Receiving regulatory approval for the EFIRM technology and also having the opportunity to present our research findings at a major cancer research meeting proves that salivary diagnostics must be integrated with mainstream, cutting-edge cancer early detection, screening and risk assessment,” Dr. Wong said.

The way we think about cancer is about to change. What we used to treat as a random occurrence is becoming both predictable and preventable through an array of emerging circular biomarkers. Through the use of circulating tumor cells, cell-free circulating DNA, exosomes, exomers, oncosomes and other extracellular vesicles, we are now able to understand early stages of cancer and apply molecular profiling to clinical trial selection, patient treatment and minimal residual disease detection. The applications are expanding outside of cancer to include transplant medicine, cardiovascular disease, CNS, autoimmune and infectious disease. Encounter the latest research results and clinical trial data while networking with leaders in the field. Final Agenda Day 1 | Day 2 | Day 3 | Download Brochure Scientific Advisory Board Stefanie Jeffrey, MD, John and Marva Warnock Professor, Surgery; Chief, Surgical Oncology Research, Stanford University School of Medicine Stuart S. Martin, PhD, Professor, Physiology, Marlene and Stewart Greenebaum NCI Comprehensive Cancer Center, University of Maryland School of Medicine Catherine Alix-Panabières, PhD, Director, Laboratory of Rare Human Circulating Cells (LCCRH), Pathology and Onco-Biology Department, University Medical Center of Montpellier Klaus Pantel, MD, Professor and Founding Director, Institute of Tumor Biology, University, Medical Center Hamburg-Eppendorf Steven A. Soper, PhD, Professor, Micro and Nanofabricated Tools for Biological Discovery and Medical Diagnostics, University of Kansas Shannon L. Stott, PhD, Assistant Professor, Department of Medicine, Massachusetts General Hospital, Harvard Medical School; BioMEMS Resource Center, The MGH Cancer Center Arrive Early for: SUNDAY, MARCH 10, 2:00 - 5:00 PM (AFTERNOON SHORT COURSES) SC4: Translating CTCs and ctDNA for Clinical Use - Detailed Agenda SUNDAY, MARCH 10, 5:30 - 8:30 PM (DINNER SHORT COURSES) SC14: Liquid Biopsy Technologies and Applications - Detailed Agenda MONDAY, MARCH 11, 8:00 - 11:00 AM (MORNING SHORT COURSES) SC21: Detection and Characterization of Circulating Biomarkers - Detailed Agenda MONDAY, MARCH 11 10:30 am Conference Program Registration Open OPENING KEYNOTE SESSION: WHAT NEEDS TO BE DONE TO BRING CTCS TO THE CLINIC? NEXT STUDIES 11:50 Chairperson’s Opening Remarks Klaus Pantel, MD, Professor and Founding Director, Institute of Tumor Biology, University, Medical Center Hamburg-Eppendorf   12:00 pm Circulating Tumor Cells in Breast Cancers: Current Clinical Validity and Utility François-Clément Bidard, MD, PhD, Professor of Medical Oncology, Institut Curie & Versailles St. Quentin University Numerous clinical data have been collected regarding the clinical validity of CTC count and characterization in both early and advanced breast cancer patients. After having reviewed these data, we will discuss how CTC detection may help customize breast cancer therapy. 12:20 Critical Assessment of the Challenges of Using Blood-Based Biomarkers in Prostate Cancer from a Clinical Point of View Daniel C. Danila, MD, Medical Oncology Fellow, Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center In addition to determining whether circulating tumor cells (CTC) can be used as prognostic biomarkers for patients needing further therapy, current studies have proposed many predictive and pharmacodynamic biomarkers to facilitate the doctor’s ability to optimize and adjust dosage based on their ability to target specific pathways. Significant efforts have been focused on developing and analytically validating predictive biomarkers to select patients most likely to benefit the specific therapy. 12:40 PANEL DISCUSSION 1:00 Session Break 1:10 Luncheon Presentation I to be Announced       1:40 Luncheon Presentation II to be Announced 2:10 Session Break NUCLEIC ACID ANALYSIS IN EXTRACELLULAR VESICLES AND CTCS 2:30 Chairperson’s Remarks Klaus Pantel, MD, Professor and Founding Director, Institute of Tumor Biology, University, Medical Center Hamburg-Eppendorf 2:40 The Whole Transcriptional Landscape of Circulating Tumors Cells in Metastatic Breast Cancer Julie E. Lang, MD, Associate Professor of Clinical Surgery; Director, Breast Cancer Program, Department of Surgery, Keck School of Medicine, University of Southern California The aim of our study was to evaluate if RNA Seq of circulating tumor cells could serve as a surrogate for biopses of macrometastases. We evaluated treatment opportunities based on circulating tumor cell profiles and tracked them under the selection pressure of systemic therapy in Stage IV breast cancer. RNA Seq of circulating tumor cells may be used to discover molecular alterations that are potentially clinically actionable. 3:10 Large Oncosomes as a Source of Cancer-Specific Circulating Biomarkers Dolores Di Vizio, MD, PhD, Division of Cancer Biology and Therapeutics, Departments of Surgery, Biomedical Sciences and Pathology and Laboratory Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center Extracellular vesicles (EVs) are heterogeneous membrane enclosed structures harboring molecular cargo from the cell of origin. Large oncosomes are a novel subtype of EV that is released by highly migratory cancer cells. Large oncosomes contain abundant tumor-derived cargo, which can be analyzed upon purification from plasma and other biological fluids. Here we show analyses of protein, RNA and DNA in controlled system and patient plasma. 3:40 Molecular Analysis of Circulating Tumor Cells, Extracellular Vesicles and Nucleic Acids as Liquid Biopsy in the Follow-Up of Metastatic Breast Cancer Patients to Stratify Patients for Targeted Therapy Prof. Dr. Sabine Kasimir-Bauer, Head of Research Laboratory, Department of Gynecology and Obstetrics, University Hospital Essen The so-called liquid biopsy is discussed to be a surrogate marker for therapy stratification of metastatic breast cancer patients. We compared and analyzed RNA profiles enclosed in circulating tumor cells or extracellular vesicles and performed mutational analysis of cell-free DNA (cfDNA) in plasma samples (Next Generation Sequencing) in the follow-up of the disease to get insights into their feasibility for therapy stratification and to predict therapeutic options. 4:10 An Open, End to End, and Flexible Platform for Scalable CTC Collection, Identification, and Analysis Tad George, PhD, Senior Director of Platform, Applications, RareCyte RareCyte provides instrumentation and consumables that enable an exquisitely sensitive, accurate, simple, and repeatable workflow from liquid biopsy to single cell isolation. The open and end to end RareCyte CTC workflow will be the focus of this talk. 4:40 Refreshment Break and Transition to Plenary Session 5:00 Plenary Keynote Session 6:00 Grand Opening Reception in the Exhibit Hall with Poster Viewing 7:30 Close of Day Day 1 | Day 2 | Day 3 | Download Brochure TUESDAY, MARCH 12 7:30 am Registration Open and Morning Coffee 8:00 Plenary Keynote Session 9:15 Refreshment Break in the Exhibit Hall with Poster Viewing CTCS AND LIQUID BIOPSY – NEW WINDOW INTO SELECTING BEST TREATMENT FOR PATIENTS 10:15 Chairperson’s Remarks Stuart S. Martin, PhD, Professor, Physiology, Marlene and Stewart Greenebaum NCI Comprehensive Cancer Center, University of Maryland School of Medicine 10:25 Chemotherapy-Induced Pro-Metastatic Changes in Breast Cancer Microenvironment Maja H. Oktay, MD, PhD, Professor of Pathology, The L.G. Koss Division of Cytology, Montefiore Medical Center; Professor of Anatomy and Structural Biology; Director, Clinical Imaging Applications, Integrated Imaging Program, Michael F. Price Center for Genetic and Translational Medicine, Albert Einstein College of Medicine Chemotherapy may induce pro-metastatic changes within breast cancer microenvironment in both mouse and human breast cancer and subsequent hematogenous cancer cell dissemination to distant sites. Cellular and molecular mechanism involved in chemotherapy-mediated cancer cell dissemination as well as pharmacological inhibitors of this process will be discussed. 10:55 RNA Signatures in CTCs for Precision Cancer Medicine David T. Miyamoto, MD, PhD, Assistant Professor, Radiation Oncology, Harvard Medical School; Department of Radiation Oncology, Center for Cancer Research, Massachusetts General Hospital CTC analysis is a type of liquid biopsy that enables RNA expression profiling, an analysis not possible with ctDNA. Microfluidic enrichment of CTCs followed by RNA-based digital PCR enables the high-throughput and highly specific detection of CTC molecular signatures in several cancers. These CTC signatures can predict therapeutic responses and may enable the early detection of invasive cancers, thus guiding the precision management of cancer patients. 11:25 Assessing PD-L1 Expression on CTCs and Correlation with Immunotherapy Response Rajan Kulkarni, MD, PhD, Assistant Professor, Dermatology and CEDAR/Knight Cancer Institute, Oregon Health and Science University PD-1 inhibitors have promising efficacy in several cancers. Circulating tumor cell (CTC) PD-L1 levels could supplement tissue PD-L1 biopsy results by sampling from disseminated tumor sites. Towards establishing CTCs as a screening tool, we developed a protocol to isolate CTCs at high purity and immunostain for PD-L1. Monitoring of PD-L1 expression on CTCs could be an additional biomarker that may help in determining response to immunotherapies. 11:55 Molecular Heterogeneity as Expressed in Cells from Liquid Biopsies Using CellSearch and DepArray in Multiple Myeloma Steven Gross, PhD, Head, CellSearch Assay Development, Research & Development, Menarini Silicon Biosystems Inc Exploring the molecular heterogeneity as expressed in cells using CellSearch and DepArray technologies in multiple myeloma and other cancers. 12:10 pm Sponsored Presentation (Opportunity Available) 12:25 Session Break 12:35 Luncheon Presentation I : Esophageal Adenocarcinoma: Circulating Tumor Cells in Multimodal Treatment Protocols Jasmina Kuvendjiska, PhD, Surgery, Freiburg University Our study was designed as a pilot study of the ESOPEC-Trial. We evaluated the presence and morphology of CTCs during the treatment period. The experimental results will be correlated with patients’ overall and relapse-free survival.   1:05 Luncheon Presentation II to be Announced 1:35 Refreshment Break in the Exhibit Hall with Poster Viewing TECHNOLOGIES FOR LIQUID BIOPSY 2:05 Chairperson’s Remarks Steven A. Soper, PhD, Professor, Micro and Nanofabricated Tools for Biological Discovery and Medical Diagnostics, University of Kansas 2:10 Diagnosing Disease with Rare Circulating EVs: Finding Heterogeneous, Nanoscale Needles in a Nanoscale Haystack David A. Issadore, PhD, Assistant Professor, Bioengineering & Electrical & Systems Engineering, University of Pennsylvania Circulating EVs contain a wealth of proteomic and genetic information, presenting an enormous opportunity for liquid biopsy. While microfluidics have been used to successfully isolate cells from complex samples, scaling these approaches for EV isolation has been limited by the low throughput and susceptibility to clogging of nanofluidics. Moreover, the analysis of EV biomarkers is confounded by substantial heterogeneity between patients and within a disease itself. To address these challenges, we developed a multichannel nanofluidic system to analyze crude clinical samples. Using this platform, we isolated EVs, profile the RNA cargo inside of these EVs, and apply a machine learning algorithm to generate predictive panels that could provide useful diagnostics for applications in traumatic brain injury and pancreatic cancer using both murine models and clinical samples. 2:40 Single Cell Morphogenomic and Morphoproteomic Profiling of Liquid Biopsy in Prostate Cancer Paymaneh D. Malihi, PhD Candidate, USC Michelson Center for Convergent Bioscience Peter Kuhn, PhD, Dean’s Professor of Biological Sciences and Professor of Biological Sciences, Medicine, Biomedical Engineering, and Aerospace and Mechanical Engineering and Associate Director, The Bridge, University of Southern California Tumor heterogeneity is prevalent in both treatment-naïve localized and end-stage metastasized prostate cancer, and may contribute to the broad range of clinical presentation, treatment response, and disease progression. High Definition-Single Cell Analysis enables morphoproteomic and morphogenomic profiling of single cells from touch preparations of tissue cores as well as liquid samples. HD-SCA platform enables real-time molecular profiling of cells and has the potential to elucidate the origin and evolution of metastatic tumor cells. 3:10 High Precision Isolation and Analysis of Exosomes Daniel T. Chiu, PhD, A. Bruce Montgomery Professor of Chemistry and Bioengineering, University of Washington We have recently developed microfluidic and nanofluidic systems for the isolation and analysis of exosomes, offering detailed molecular information with single-exosome resolution. Here, we will describe our technical approach, device performance, and the new information we learned about exosomes as revealed by the new measurements. 3:40 Presentation to be Announced   3:55 Talk Title to be Announced Christoph Mauracher, PhD, Managing Director, STRATEC Consumables GmbH 4:10 St. Patrick’s Day Celebration in the Exhibit Hall with Poster Viewing 5:00 Breakout Discussions in the Exhibit Hall Parallel Analysis of Circulating Biomarkers in Immunotherapy Genevieve Boland, MD, PhD, Director, Melanoma Surgery Program, Massachusetts General Hospital; Director, Surgical Oncology Research Laboratories, Massachusetts General Hospital; Assistant Professor, Harvard Medical School; Associate Member, Broad Institute Clinical application of blood-based biomarkers in melanoma Unmet clinical needs in blood-based biomarkers Microvesicle applications in immunotherapy Clinical Utility and Impact of Liquid Biopsy Rajan Kulkarni, MD, PhD, Assistant Professor, Dermatology and CEDAR/Knight Cancer Institute, Oregon Health and Science University Necessary features of technologies/tests for clinical utility Tumor information that is of clinical relevance Necessity for standardization The Importance and Challenge in CTC Culture Professor Yong-Jie Lu, MBBS, MD, PhD, Professor, Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London Why is CTC culture important? What is the challenge? Does it worth to try it? Alternative ways to avoid it? How can we success with CTC culture? The researcher, technology development and the funding supporter/policy marker. Deploying Bioengineered 3D Tumor Models into Clinical Practice and the Pharmaceutical Pipeline Aleksander Skardal, PhD, Assistant Professor, Regenerative Medicine, Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine Where is the clinical enterprise and/or pharma in terms of seeing value in these model systems? How do we convince clinicians and more traditional scientists that these new technologies are important and effective? 3D models are typically better representations of in vivo biology; Why the slow adoption? (besides decreased throughput) Complexity (more cell types or multiple organoids per model system) versus scale-up/high throughput Simple tumor organoids (aka spheroids) are amenable to medium-high throughput screening. What about multi-organ system (aka body-on-a-chip)? Where in the pharmaceutical pipeline do more advanced systems that are less amenable to high throughput fall? Post-preclinical/pre-human Phase I? Serve as go/no go points? Isolation and Analysis of CTCs Min Yu, MD, PhD, Assistant Professor, Stem Cell Biology and Regenerative Medicine Member, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California Downstream analysis of circulating tumor cells Technologies for CTC isolation Experimental mouse models for metastasis analysis Using CTCs as liquid biopsy 6:00 Close of Day Day 1 | Day 2 | Day 3 | Download Brochure WEDNESDAY, MARCH 13 7:30 am Registration Open and Morning Coffee 8:00 Plenary Keynote Session > 10:00 Refreshment Break and Poster Competition Winner Announced in the Exhibit Hall CIRCULATING BIOMARKERS INFORMING CLINICAL TRIALS 10:50 Chairperson’s Remarks Stefanie Jeffrey, MD, John and Marva Warnock Professor, Surgery; Chief, Surgical Oncology Research, Stanford University School of Medicine 11:00 Utilizing Extracellular Vesicles for Prediction and Monitoring of Immunotherapy Responses in Melanoma Genevieve Boland, MD, PhD, Director, Melanoma Surgery Program, Massachusetts General Hospital; Director, Surgical Oncology Research Laboratories, Massachusetts General Hospital; Assistant Professor, Harvard Medical School; Associate Member, Broad Institute Immune checkpoint inhibitors (ICI) show therapeutic benefit in melanoma. We identified pretreatment and early on-treatment biomarkers that incorporate tumor and host immune status. Our findings suggest that peripheral blood-derived exosomes may serve as a non-invasive biomarker to probe tumor and immune responses to ICI therapy, functioning as both a predictive marker of ICI responsiveness as well as a monitoring tool for tumor persistence and immune activation. 11:30 Molecular Assessment of Circulating Extracellular Vesicles Toward Liquid Biopsy Diagnosis of Gastrointestinal Stromal Tumor and Ewing Sarcoma Andrew K. Godwin, PhD, Chancellors Distinguished Chair in Biomedical Sciences and Endowed Professor and Director, Molecular Oncology, Professor, Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Deputy Director, University of Kansas Cancer Center There is growing interest in exploiting circulating extracellular vesicles (EVs), primarily small bioactive nanovesicles (60–120 nm), known as exosomes, as developing sources of biomarkers for diagnosis and therapeutic response. However, EVs are heterogeneous vesicles released by both healthy and tumors cells, with the vast majority of circulating vesicles being derived from normal host cells. To establish their utility as valuable tools for the diagnosis of cancer and therapeutic monitoring of disease progression and response to therapy, we used molecular approaches to profile the proteome of Gastrointestinal Stromal Tumor (GIST)- and Ewing Sarcoma (EWS)-derived EVs, as well as other types of cancer, which provided insights into the oncogenic cargo of these tumor-derived EVs. Using proteins enriched in these different sarcomas, we have developed microfluidic platforms and immunocapture approaches to target tumor-associated EVs and in turn measure exosomal proteins and/or RNAs specific to a cancer subtype to further enhance the specificity of these liquid-based biopsies. 12:00 pm Clinical Trials – Liquid Biopsy in Lung Cancer Lecia V. Sequist, MD, Hematology/Oncology, Massachusetts General Hospital We will review the wide variety of liquid biopsy assays that have been used in clinical trials for lung cancer patients, and how this is affecting practice in the real world. 12:30 Session Break 12:40 Luncheon Presentation (Sponsorship Opportunity Available) or Enjoy Lunch on Your Own 1:10 Refreshment Break in the Exhibit Hall and Last Chance for Poster Viewing NEW MODELS OF MECHANISMS OF CANCER DISSEMINATION 1:50 Chairperson’s Remarks Shannon L. Stott, PhD, Assistant Professor, Department of Medicine, Massachusetts General Hospital, Harvard Medical School; BioMEMS Resource Center, The MGH Cancer Center 2:00 Advanced in vitro Cancer Models: Metastasis-on-a-Chip and Patient-Derived Organoid Technologies Aleksander Skardal, PhD, Assistant Professor, Regenerative Medicine, Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine Most in vitro models of human tumors are too simplistic and fail to accurately recapitulate the in vivo tumor microenvironment. This presentation will describe 1) development of a microfluidic platform supporting observable metastasis from a primary site organoid to downstream target organoids, and 2) the translation of organoid technology to support models derived from clinical tumor biospecimens for personalized ex vivo drug screening and therapeutic efficacy identification prior to treatment. 2:30 Patient-Derived Circulating Tumor Cells Inform Mechanisms of Metastasis Min Yu, MD, PhD, Assistant Professor, Stem Cell Biology and Regenerative Medicine Member, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California Circulating tumor cells (CTCs) are expected to contain metastasis-initiating cells that can shed light on the mechanisms of cancer metastasis. However, due to limited patient-derived material, the metastatic capability of CTCs has yet to be proved. Using our recently established patient-derived CTC lines, we found that different patient CTC lines demonstrated distinct metastatic tissue tropisms in immunodeficient mice and identified associated pathways to specific organs via RNA-seq and ATAC-seq analysis. 3:00 From Sample-to-Single Cells-to-Answer – An Integrated Microfluidics Approach for Identifying Cancer Cells Abraham “Abe” Lee, PhD, William J. Link Professor and Chair, Department of Biomedical Engineering (BME); Professor, Mechanical & Aerospace Engineering; Director, NSF I/UCRC CADMIM Research Lab: Biomolecular Microsystems and Nano Transducers (BioMiNT), University of California, Irvine Liquid biopsy is performed by a microfluidic acoustic microstreaming device to isolate and target circulating tumor cells (CTCs) in whole blood. A key bottleneck is to identify the critical subpopulation of cells, often at single cell resolution among billions of cells in circulation. An in vitro perfused vascularized 3D tissue platform can then determine which CTCs can be disseminated to distant tissues through the circulatory system. 3:30 Session Break EXPANSION OF CIRCULATING TUMOR CELLS: A CHALLENGE! 3:40 Chairperson’s Remarks Catherine Alix-Panabières, PhD, Director, Laboratory of Rare Human Circulating Cells (LCCRH), Pathology and Onco-Biology Department, University Medical Center of Montpellier 3:45 Expansion of Patient-Derived Circulating Tumor Cells from Liquid Biopsy Chwee Teck (C.T.) Lim, PhD, NUS Society (NUSS) Professor, Department of Biomedical Engineering; Director, Biomedical Institute for Global Health Research and Technology; Founding Principal Investigator, Mechanobiology Institute, National University of Singapore Personalized therapy in cancer requires monitoring of patients’ individual response to treatment. One approach is to assess drug efficacy on circulating tumor cells (CTCs) obtained from patients’ blood samples (aka liquid biopsy) following ex vivo expansion into CTC clusters. We developed a simple microfluidics-based culture platform that allows co-culture of immune cells with CTCs (obtained after red blood cell lysis of patients’ blood) to promote CTC cluster formation. 4:15 Holy Grail and Big Challenge – Culture of Circulating Tumor Cells Yong-Jie Lu, MBBS, MD, PhD, Professor, Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London Circulating tumor cells (CTCs) provide a minimally invasive approach to access living cancer cells. The culture of CTCs enables the investigation of their biological features, mechanisms of cancer metastasis and the opportunity for in vitro therapeutic sensitivity tests. Challenge to CTC culture includes their rarity, small proportion of viable cells and unclear favorable growth condition. I will give a brief summary of culture strategies and our own experience. 4:45 Growing Organoids from CTCs: The Importance of CTC Input Andrew Rhim, PhD, Associate Director for Translational Research Ahmed Center for Pancreatic Cancer Research Assistant Professor of Internal Medicine UT MD Anderson Cancer Center Liquid biopsies have potential to inform personalized treatments and decision making in patients with cancer. While still in its infancy, the field has exploded, featuring numerous modalities and source material, including circulating tumor cells (CTCs), circulating nucleic acids, exosomes, and others. CTCs, however, hold the greatest promise, as not only do they contain all the tumor-derived material that are in the circulation, but if they could be cultured and propagated ex vivo, the prospect of functional analysis and direct drug combination testing could direct true individualized cancer care. Moreover, since CTCs are in the circulation, serial assay of CTCs, during the throes of treatment, could allow for nimble decision-making to thwart resistance. The major hurdle in the application of CTCs in the clinic is the inability to establish CTC cultures. Our laboratory has hypothesized that the major determinant of culture success is the number of CTCs seeded. This hypothesis is driven in part by evidence suggesting that a sub population of tumor cells retain stem cell like characteristics, called cancer stem like cells. These cells are theorized to be required to initiate tumors and metastases since they possess the capacity for self-renewal. In current protocols, at most 60ml of blood is phlebotomized for CTC isolation. However, we estimate that this yields far too few cancer stem like cells to achieve success in culture. Here we will review the efforts we have undertaken to achieve robust and routine cultures of CTCs, mostly by focusing on dramatically increasing CTC input with less emphasis on epithelial cell purity. In so doing, our preliminary data suggest real promise in our approaches. 5:15 Close of Conference Program Stay Late for:  MARCH 14-15 TS4: Introduction to Liquid Biopsy for Cancer - Detailed Agenda Day 1 | Day 2 | Day 3 | Download Brochure