Cancers arise within the cells of an organ, such as the breast or pancreas, but cause death by disseminating throughout the bloodstream, spreading — or metastasizing — to the bone, liver, lungs or brain.
Cancer cells that spread from the primary tumor can be found in the blood of patients with cancer. These circulating tumor cells (CTCs) are extraordinarily rare — there is one per one billion normal cells. The ability to detect and analyze them would allow for significant advances in detecting and treating cancers as well as understanding the fundamental mechanisms by which cancers spread.
Technology available to date has not proved to be either sensitive or reliable enough to allow detection and analysis of these cells or to be useful in guiding treatment decisions.
In this project, a collaboration of clinicians, bioengineers and molecular biologists has developed a novel and radically different approach to detecting and isolating CTCs. This technology takes advantage of microscopic fluid dynamics to construct a Chip with 100 times greater sensitivity than existing technologies. The CTC-Chip is the size of a business card and contains 78,000 microscopic columns, each coated with material capable of attaching to CTCs while allowing normal blood cells to flow through unimpeded.
The CTC-Chip can capture approximately 200 CTCs from a teaspoon of blood taken from a cancer patient, making these cells available for scientific analysis, providing an important tool for clinical investigation, and ultimately leading to improved clinical care for patients with cancer.
The potential clinical applications of this technology are widespread and have the potential to revolutionize the ways in which cancers are detected and treated. The CTC-Chip could make it possible to analyze cancers of the internal organs in real time, non-invasively, both at the time of diagnosis and throughout treatment. This would enable clinicians to match patients to effective therapies and monitor the response to treatments.
Specific Research Goals:
- Optimize the technology of the CTC-Chip to make it more sensitive and assure that it can be used reliably and efficiently in a large-scale clinical setting.
- Conduct clinical trials to assess the value of the Chip in detecting cancers early or monitoring tumor response to treatment. The trials will involve a wide range of cancers (including breast, pancreatic, prostate and colon).
- An additional goal for the CTC-Chip is to make it sufficiently sensitive to detect cancers at an earlier stage. Studies indicate that tumors may start shedding CTCs into the bloodstream long before they actually metastasize to distant organs, opening the door for early detection and screening strategies.
This SU2C Dream Team has developed a microfluidic chip – smaller than a business card – to detect and analyze cancer cells circulating in our blood. They are working on an improved version of the chip to better look at the genetic and functional characteristics of CTCs in a large-scale clinical setting. This technology will be used to answer questions about how cancer spreads throughout the body, how to detect metastatic cancer early, and most importantly how to stop it from occurring.
Sangeeta N. Bhatia MD, PhD, professor of HST/EECS (health sciences and technology/electrical engineering and computer science), Massachusetts Institute of Technology
Mark G. Kris, MD, chief of thoracic oncology service, Memorial Sloan Kettering Cancer Center
Bruce E. Johnson, MD, professor of medicine, Dana-Farber Cancer Institute
John V. Heymach, MD, PhD, associate professor, Department of Thoracic/Head and Neck Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center