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EMBO Mol Med. 2014 Oct 30;6(11):1371-86. doi: 10.15252/emmm.201404033.

Molecular profiling of single circulating tumor cells with diagnostic intention.

Author information

  • 1Project Group "Personalized Tumor Therapy", Fraunhofer Institute for Toxicology und Experimental Medicine, Regensburg, Germany.
  • 2Silicon Biosystems S.p.A., Bologna, Italy.
  • 3Experimental Medicine and Therapy Research, University of Regensburg, Regensburg, Germany.
  • 4Division of Laboratory Medicine, European Institute of Oncology, Milan, Italy.
  • 5Department of Gynecology and Obstetrics, University Munich, Munich, Germany.
  • 6Department of Gynecology and Obstetrics, University of Düsseldorf, Düsseldorf, Germany.
  • 7Project Group "Personalized Tumor Therapy", Fraunhofer Institute for Toxicology und Experimental Medicine, Regensburg, Germany Experimental Medicine and Therapy Research, University of Regensburg, Regensburg, Germany.
  • 8Department of Pathology, University Erlangen, Erlangen, Germany.
  • 9Department of Gynecology and Obstetrics, University Erlangen, Erlangen, Germany.
  • 10Project Group "Personalized Tumor Therapy", Fraunhofer Institute for Toxicology und Experimental Medicine, Regensburg, Germany Experimental Medicine and Therapy Research, University of Regensburg, Regensburg, Germany christoph.klein@klinik.uni-regensburg.de.

Abstract

Several hundred clinical trials currently explore the role of circulating tumor cell (CTC) analysis for therapy decisions, but assays are lacking for comprehensive molecular characterization of CTCs with diagnostic precision. We therefore combined a workflow for enrichment and isolation of pure CTCs with a non-random whole genome amplification method for single cells and applied it to 510 single CTCs and 189 leukocytes of 66 CTC-positive breast cancer patients. We defined a genome integrity index (GII) to identify single cells suited for molecular characterization by different molecular assays, such as diagnostic profiling of point mutations, gene amplifications and whole genomes of single cells. The reliability of > 90% for successful molecular analysis of high-quality clinical samples selected by the GII enabled assessing the molecular heterogeneity of single CTCs of metastatic breast cancer patients. We readily identified genomic disparity of potentially high relevance between primary tumors and CTCs. Microheterogeneity analysis among individual CTCs uncovered pre-existing cells resistant to ERBB2-targeted therapies suggesting ongoing microevolution at late-stage disease whose exploration may provide essential information for personalized treatment decisions and shed light into mechanisms of acquired drug resistance.

KEYWORDS:

breast cancer; circulating tumor cells; metastasis; single cell analysis

PMID:
25358515
PMCID:
PMC4237466
DOI:
10.15252/emmm.201404033
[PubMed - indexed for MEDLINE]
Free PMC Article
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