IDENTIFICATION AND MOLECULAR ANALYSIS OF CIRCULATING BRAIN TUMOR CELLS
Led by Brian Vala Nahed at Massachusetts General Hospital
Glioblastoma multiforme (GBM) is defined by uncontrolled cellular proliferation, central necrosis, angiogenesis, and inevitable recurrence resulting in a two-year patient survival of 25%. Despite advances in research, surgery, medical and radiation therapy, we remain limited in our ability to accurately determine tumor response and recurrence. Currently, magnetic resonance imaging (MRI) is used to monitor therapeutic response and detect tumor recurrence; however, it is limited in its accuracy to distinguish tumor recurrence from tissue response to radiation therapy. As a result, patients often undergo an additional surgical procedure for definitive tissue diagnosis. This process isfurther limiting in that a biopsy provides information from a single time point; it does not allow clinicians to monitor tumor response or recurrence over a period of time. GBM’s rarely metastasize which has led to the assumption that glioma cells could not be found in the peripheral blood. This theory has been upheld by limited technology which lacked the biochemical sophistication needed to identify circulating glioma cells. Adapting advances from our laboratory, I developed the first device to successfully capture and isolate circulating tumor cells (CTC) from venous blood. Using this novel device, CTC can be captured and analyzed with
sophisticated pathological staining methods to detect molecular and genetic changes. The GBM CTC capture device grants unparalleled access to identify, isolate, and characterize circulating GBM cells; I envision it to be a diagnostic tool, a measure of therapeutic effect, and ultimately the most accurate detection of tumor recurrence; all of which will advance our understanding and treatment of GBM.
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