CTC for non invasive theranostics

Theranostics is an emerging domain of medicine, named after a contraction of the words therapy and diagnostics, which is expected to revolutionize predictive oncology and implement personalized medicine. It allows tailoring to individual patients new targeted treatments which are selected based on molecular characteristics of cancer cells allowing to predictably obtain the cancer’s response to treatment.
Theranostics markers already exist and are used on tissues (primary tumors, metastasis). Targeting theranostic tests to Circulating Cancer Cells and Microemboli isolated by ISET allows the follow up of invasive cancers and tailoring the treatment based on real time analyses of the evolving tumor cell populations.
  • 18 ALK-positive patients
  • 14 ALK-negative patients
  • 100% consistent result (T, CTC)
  • 100% of patients with detectable CTCs by ISET
Single cell analysis: ALK-rearranged CTCs expressed a mesenchymal phenotype contrasting with heterogenous epithelial and mesenchymal marker expressions in tumors. ALK-rearranged CTCs harbored a unique split pattern, and heterogeneous patterns of splits were present in tumors.
A representative example of vimentin/cytokeratins/ CD45/DAPI fluorescent staining of ALK-rearranged CTCs in an ALK-positive patient.
  • 256 non-small-cell lung cancer patients (stage III-IV)
  • 106 lung adenocarcinoma patients (stage III-IV)
  • CTC detected by ISET in 75% of patients (all stages)
93% concordance of MET expression on CTC and matched patient tissue
MET protein staining in tumor tissue and corresponding CTCs from selected NSCLC patients.
  • 8 metastatic non-small-cell lung cancer patients
  • 4 ROS1-rearranged tumors
  • ROS1 rearrangement was detected in CTCs of all 4 patients with ROS1-rearranged primary tumor