Xconomist of the Week: Peter Kuhn on Detecting Circulating Tumor Cells

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Kuhn agreed to answer a few questions about the technology, and how broader advances in molecular diagnostics are expected to dovetail with the emerging fields of quantified health and personal medicine.

Xconomy: Does the type of primary tumor make any difference as a source for circulating tumor cells?

Peter Kuhn: We are only talking about the carcinomas—so the approximately 7 million Americans with breast, prostate, pancreatic, lung, ovarian, liver and kidney cancers. We have known for a very long time that cancer spreads through the blood. It’s just that we haven’t had the analytical tools to really track down the disease-derived cells. In terms of your question, we’re seeing different rates of cell [proliferation], and different types of cells in the different cases. In each case, [there is a] high degree of heterogeneity.

X: What’s the breakthrough that makes this possible?

PK: The set of fundamental breakthroughs intellectually was a) the recognition that there is a large degree of heterogeneity of these cells in the human blood, and b) being conscious of what it means to be dealing with the challenge of a needle-in-the-haystack type of problem.

Kelly Bethel and Peter Kuhn

We had to bring together deep vertical expertise in engineering and math with pathology and oncology. All parties had the simple unifying goal of doing something that could have real impact on individual patients at some point in the near future. The most important thing, you know, is to flip a challenge into an opportunity. That is what we did with the way we are preparing the samples as well as the way in which we are analyzing the data.

The analysis is a large-scale form of backend computing that has grown out of a longstanding collaboration with Microsoft. More and more, scientists are using fluorescently tagged antibodies to label particular proteins in cells. So we started using a very standard approach, of using these fluorescing antibodies to label these cells. Then we had to translate that into something that was technologically robust and that we could calibrate within and across sample.

X: How long have you been working on this?

PK: We began collecting the data that went into the papers two and a half years ago. We were funded with … Next Page »

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Bruce V. Bigelow is the editor of Xconomy San Diego. You can e-mail him at bbigelow@xconomy.com or call (619) 669-8788 Follow @bvbigelow

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  • The availability of CTC tests is important to two groups of patients: Those at the time of diagnosis, so that therapy can be tailored for both the primary tumor and monitoring recurrence in ‘survivors’ as an early warning system, to permit intervention before the there is clinically evident metastatic disease.

    The National Reference Laboratory for Breast Health launched the ArgusCYTE Breast Health Test in December 2011, to provide information to help inform breast cancer treatment options and to help monitor potential recurrence. It can monitor breast cancer distant recurrence by obtaining a “liquid biopsy” or blood sample, and analyzing it for the presence of circulating tumor cells, which can then be analyzed to determine the expression of Estrogen Receptor/Progesterone Receptor, or ER/PR, and Human Epidermal Growth Factor Receptor, or Her2, in those cells, a predictor of the cancer’s sensitivity to existing treatment options. The presence of circulating tumor cells in the blood sample may serve as an early indicator of the recurrence of breast cancer and the data obtained from the ArgusCYTE sensitivity analysis may help physicians better select which treatment options to use with a particular patient.

    This is available today for doctors and patients.