CTC detection

has been undertaken using this assay in bladder cancer (15-17), melanoma (18), lung (19) in addition to other solid tumors. CTC detection using Cellsearch has also been evaluated in small studies to monitor chemotherapy outcomes in hepatocellular and pancreatic cancer (20,21). Cholangiocarcinoma is a rare type of cancer with rising incidence worldwide (22) and carries a very poor prognosis. Cancers of the bile duct include tumors arising in the intra and extra hepatic bile ducts (called cholangiocarcinoma) as well as cancer of the gall bladder. Most patients have advanced disease at presentation and survival is often short. Therapy for these patients is intended Inhibitors,research,lifescience,medical to be palliative and quality of life is often poor, hence early knowledge Inhibitors,research,lifescience,medical of the likelihood of benefit from different therapies could be very useful to guide management. No studies have yet been done to examine the detection of CTCs in cholangiocarcinoma and gallbladder cancer using immunomagnetic assays thus the cut off for a positive CTC value has not yet been defined. Since EpCAM is overexpressed in gallbladder Inhibitors,research,lifescience,medical cancer

and cholangiocarcinoma (63-100 and 81-90% respectively) (23) we hypothesized that CTCs can be detected and might correlate with stage of disease. Methods Patients With IRB approval, sixteen patients from Roswell Park Cancer Institute with cholangiocarcinoma or gallbladder cancer that had at least one CTC measurement were included. This selleck kinase inhibitor included all patients

with histological diagnosis of cholangiocarcinoma or gallbladder cancer Inhibitors,research,lifescience,medical which was the only inclusion criteria. Samples were collected and analyzed using the CellSearch assay. Clinical follow up and sample collection occurred between June 2008 and May 2011. To evaluate patients survival and its correlation with CTC status, patients were divided into two groups, group one (G1) were patients with negative or 1CTC/7.5 mL and group two (G2) were patients with 2 or more CTC/ 7.5 mL. Overall survival was defined Inhibitors,research,lifescience,medical as the time of follow up between the first CTC detected and the survival (censored at May 2011). Progression free survival was defined as the time of follow up between the first CTC and the first progression on CT scans according to WHO criteria. CTC assay The circulating Histone demethylase tumor cells (CTC) were detected using the CellSearch assay by Veridex LLC, Raritan, NJ (24,25). The CellSearch assay enumerates only CTC that express EpCAM and cytokeratins (CK) 8, 18, and 19. The CellSearch epithelial cell kit (Veridex LLC) contains an anti-EpCAM ferrofluid capture reagent and immunofluorescent reagents. The anti-EpCAMferrofluid reagent consists of nanoparticles with a magnetic core surrounded by a polymeric layer coated with monoclonal antibodies targeting the EpCAM antigen expressed by CTCs allowing their selective capture.