Circulating tumor cells (CTCs) are cancer cells that shed from tumors and circulate through the bloodstream. The document discusses CTCs and various methods used to detect and isolate them. CTCs were first observed in 1869 and are found at very low frequencies (1-10 cells per ml of blood) in patients with metastatic cancer. Due to their rarity and heterogeneity, detecting and identifying CTCs is challenging. The document outlines several techniques used for CTC detection and isolation, including the CellSearch method, nano-particle adherence methods, and microfluidic chips. Emerging microfluidic technologies are improving CTC yields and characterization, with the goal of using CTCs as biomarkers and therapeutic targets

2. What are Circulating tumor
cells?
 These are cells which shed from a
cancerous tumor, enter the circulatory
system through the blood and affects
other organs, leading to death of that
organism.
 The first CTCs were observed in the
year 1869 by Thomas Ashworth. He
demonstrated its critical role in the
spread of metastatic
carcinoma. Ashworth, T. R (1869).
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3. CTC under Microscope
(fluorescent labeled)
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4.  Circulating tumor cells are found in
frequencies on the order of 1-10 CTC per ml
of whole blood in patients with metastatic
disease.
 They posses the characteristics which reflect
the heterogeneity of cancer.
 Hence there isolation and identification is quite
challenging and not so easily detected.
Yu M., Haber D. A., et al. (2012).
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5. DETECTION & ISOLATION
METHODS
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6. CELL SEARCH METHOD-(epithelial
cell adhesion molecule) EpCAM
method
Yu M., Haber D. A., et al. (2012).
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7. Gold based nano-particle
adherence method
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8. Mosaic CTC assay method
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9. Di-electrophoresis separation
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10. ISOFLUX SYSTEM
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11. CTC-CHIP
An Exciting New Tool to Detect Circulating
Tumor Cells in Lung Cancer and Prostate
Cancer Patients
(M. Toner,J. Kaiser)
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12.  It is a Silicon Chip of the size of standard microscopic slide.
 It has an array of 78,000µm-sized posts and they are etched
in a specific geometric pattern.
 The chip is “functionalized” with Epithelial cell adhesion
molecule (EpCAM).
 It was introduced by Dr. Mehmet Toner in the year 2007, at
Massachusetts General Hospital. (M. Toner,J. Kaiser)
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14. Fluorescent Staining of different
antibodies present within the metastatic
cells
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15. Structure of CTC lung Cancer
under Microscope
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16. Structure of CTC Breast Cancer
under Microscope
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17. Structure of CTC Colon Cancer
under Microscope
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18.  Scientists believe that Micro Fluidics will play a
significant role in promoting the study of CTCs
and advancing the race toward achieving clinical
relevance.
 Some of the Microfluidics system has already
gained importance in the world of clinical trials.
 Microfluidics has facilitated the development of
many innovative and flexible research systems
that can capture CTCs at increasingly higher
yields and facilitate all manners of downstream
characterization.
 Recent research is made to make CTCs as
therapeutic drug targets and biomarkers. (Butler
JE, Ni L)
Future Prospects…
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19. CTCs are the messenger and message of
metastasis
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20. BIBLIOGRAPHY
 Butler JE, Ni L, Nessler R, Joshi KS, Suter M, Rosenberg B, Chang J,Brown
WR, Cantarero LA: The physical and functional behavior of capture
antibodies adsorbed on polystyrene. J Immunol Methods 1992,150:77e90.
 M. Toner. (2013, January 14). Keynote Speaker. SLAS Conference: Miami,
Florida.
 J. Kaiser. (2010). “Cancer's Circulation Problem.” Science Journals. (Online
article). http://www.sciencemag.org/content/327/5969/1072.full.
 Cristofanilli M, Hayes DF, Budd GT, et al. Circulating tumor cells: a novel
prognostic factor for newly diagnosed metastatic breast cancer,J Clin Oncol
2005;23:1420 –1430.
 Ashworth, T. R (1869). "A case of cancer in which cells similar to those in
the tumors were seen in the blood after death". Australian Medical
Journal 14: 146–7.
 Yu M., Haber D. A., et al. (2012). "RNA sequencing of pancreatic circulating
tumor cells implicates WNT signaling in metastasis". Nature 487 (7408):
510–3.
 Butler JE, Ni L, Nessler R, Joshi KS, Suter M, Rosenberg B, Chang J,Brown
WR, Cantarero LA: The physical and functional behavior of capture
antibodies adsorbed on polystyrene. J Immunol Methods 1992,150:77e90
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21. 21
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