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Wearable device that harvests cancer cells from blood may improve diagnosis, treatment
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Researchers have developed a novel wearable device that captures cancer cells from blood, potentially providing better information for treatment planning than traditional biopsy, according to a press release.
Results from studies conducted in dogs may now lay the groundwork for a trial in humans.
“Nobody wants to undergo biopsy. If we could instead obtain enough cancer cells directly from the blood, we could use them to learn about the tumor biology and direct care for patients. That is the excitement of why we are doing this,” Daniel F. Hayes, MD, Stuart B. Padnos professor of breast cancer research at University of Michigan Rogel Cancer Center, said in the release.
HemOnc Today spoke with Hayes about the device, the timeline for when trials may be conducted in humans, and when this device — if proven effective — could be adopted in clinical practice.
Question: What prompted the development of this device?
Answer: When we treat cancers, we always perform a biopsy so that we know if it is cancer, from which organ it started, and whether it is making certain substances that direct us on how to best treat the patient. Tissue biopsy is standard of care, however, starting 50 years ago, people began to identify things in blood that might explain what is going on with the cancer. Then, about a decade ago, European investigators coined the term ‘liquid biopsy.’ They thought that we could look at circulating tumor cells and detect what was going on in the tissue. Liquid biopsy has gained a lot of excitement, but the trouble is in taking only one or two vials of blood. Although we obtain billions of red cells and millions of white cells, we only get maybe 10 or 15 circulating tumor cells. We would like to have more circulating tumor cells so that we can be more accurate with diagnosis and treatment.
Q: How exactly does the device work?
A: The device is approximately the size of an iPhone. Our strategy is to place a dual-lumen, IV catheter that runs from the patient’s vein to the device and back. The device has a pump, which pumps the blood into the device, and a syringe that infuses heparin so that a clot does not form outside of the body. It also has a chip that captures the circulating tumor cells and allows the rest of blood to flow back into the patient’s vein. We have studied this in experimental dog models and so far have not observed any adverse events.
Q: What research has been conducted so far?
A: We have tested the device in a dog model at the Colorado State University’s Flint Animal Cancer Center in collaboration with Douglas Thamm, VMD, professor of veterinary oncology and director of clinical research at Colorado State University. We injected healthy adult animals with human cancer cells, which are eliminated by the subjects’ intact immune systems over the course of a few hours with no lasting effects. For the first 2 hours post-injection, the subjects were given a mild sedative and connected to the device, which screened between 1% and 2% of their blood. At the same time, blood was drawn every 20 minutes, and the cancer cells in these samples were collected by a chip of the same design.
Q: What challenges must be overcome before the human trial begins?
A: We still have a lot of optimization to do. Our engineering collaborators are revising the chip to enhance the flow rate. Once that is completed, we will need to repeat our animal proof-of-principle studies. We then plan to conduct research on dogs with native cancers. We want to emphasize that this is not meant to be a therapeutic approach. We are not trying to remove cells to stop the cells from growing in the patient. This is purely for diagnosis.
Q: When might the human trial be underway and when will this device — if proven effective — be adopted in clinical practice?
A: We are maybe 3 or 4 years away from a human clinical trial. We first need to optimize the device— it is still a ‘beta unit’ at best and we need to add more bells and whistles to it before we test the device in humans. – by Jennifer Southall
Reference:
Kim TH, et al. Nature Communications. 2019;doi:10.1038/s41467-019-09439-9.
For more information:
Daniel F. Hayes, MD, can be reached at University of Michigan Rogel Cancer Center, 1500 E. Medical Center Drive, Ann Arbor, MI 48109; email: hayesdf@med.umich.edu.
Disclosure: Hayes reports the University of Michigan holds a patent on the use of circulating tumor cells to direct care of patients with breast cancer. This patent is licensed to Menarini Silicon Biosystems, the manufacturer of the CellSearch CTC system, for which Hayes reports receiving annual royalties.