Cancer is a complex disease. A typical tumor contains millions of cells that are not all identical. What constitutes a “cancer” can involve hundreds of genes, multiple kinds of mutations in those genes and various alterations of many different cellular pathways. This diversity is compounded by the fact that cancer is constantly evolving over time, especially in response to therapeutic pressure. That’s why cancer is so difficult to treat. There is no silver bullet that can attack every different kind of cancer cell in the body. It’s not one disease, but multiple diseases all at once.
To successfully treat a cancer, you have to identify and understand the molecular characteristics of the different cells in a tumor and how they are evolving over time. Epic Sciences aims to provide as much information as possible about abnormalities in cancer cells, so patients can get the right treatment at the right time. By looking at each cell individually, you gain insight into the details of its origin. We see cancer as a disease of multiple clonal species that exist in a patient, each of which has a unique genomic and proteomic profile.
A liquid biopsy is a minimally invasive alternative to traditional tissue biopsy that is used to evaluate a cancer patient’s tumor. This simple blood draw at regular intervals is intended to enable better monitoring and treatment. CTCs have long been known as a mechanism for spreading cancer throughout the body and could provide a near real-time and comprehensive view of a patient’s cancer
Types of liquid biopsy:
CTCs are specialized cells that are able to pass through membranes, leave the tumor site and enter the blood stream. They also can go back through membranes and into a different tissue, promoting the growth of additional tumors elsewhere in the body. Growth of these new tumors away from the primary site is called metastasis.
By testing and characterizing individual CTCs, you can learn about the origins of multiple tumors types and, potentially, identify the drugs that are needed to treat them. Successful treatment of these moving targets requires frequent testing so that the therapy evolves with the disease. This isn’t possible with the traditional methods of tissue biopsy. That’s why Epic Sciences’ ability to regularly characterize the cancer cells through a simple blood draw is a revolutionary step towards personalized treatment.
Not all CTCs look alike. These heterogeneous cells come in various shapes and sizes and have differential surface marker expressions and genetic aberrations. Epic Sciences’ CTC detection and characterization platform looks at all nucleated cells, providing deep insights into cancer heterogeneity. Unlike other techniques, our no cell left behind® technology doesn’t involve presorting or pre enrichment. This enables the capture of each nucleated cell regardless of its physical characteristics.
Figure 1 below illustrates the different methods that are used to isolate CTCs from the blood. Currently, there are a number of methods that pre-enrich for CTCs based on physical characteristics. The Epic Sciences CTC platform analyzes all nucleated cells within a blood sample at single cell resolution. All nucleated cells from each blood sample are deposited on glass slides and compared for morphological features (size, shape, circularity), expression of epithelial markers (cytokeratins), nuclear integrity (DAPI), expression of hematological markers (CD45) and expression of tissue/tumor/therapy specific biomarkers using immunofluorescent staining.