Although numerous drugs are available to treat cancers, determining which drugs to use can be challenging. As tumors grow, they often become resistant to treatments as cancer cells mutate quickly which can help them adapt and survive. Complex factors can make it difficult to test and predict how patient’s tumors will respond to different treatments.
Two separate research groups funded in part by NIH’s National Cancer Institute (NCI) www.cancer.gov are working to create tiny devices to test how tumors within a patient respond to various drugs. Papers describing the studies were published on the April 22, 2015 in “Science Translational Medicine.”
One team led by Dr. Oliver Jonas and Dr. Robert Langer at MIT http://web.mit.edu developed a small device that can be implanted using a standard biopsy needle. The device contains reservoirs that release tiny doses of up to 16 individual drugs or drug combinations into distinct regions. After 24 hours, a second biopsy needle is used to retrieve the device along with a small column of tissue around the device so that the tissue can be examined to assess the effects of the drug on the tumor.
The second research team led by Dr. Jim Olson at Fred Hutchinson Cancer Research Center www.fredhutch.org and Dr. Richard Klinghoffer at Presage Biosciences http://presagebio.com developed the device CIVO ™. The device uses an array of up to eight needles that can inject small amounts of candidate drugs directly into tumors.
The drugs are delivered as the needles are retracted, leaving column-like tracks of the drugs through the tumor. After 24-72 hours, tumor samples are taken and processed. The tumor’s response to each drug is then assessed with a sophisticated imaging analysis system.
The scientists tested CIVO in a clinical setting in four human lymphoma patients with no serious adverse events reported in the small pilot study. “This set the stage for a new type of pre-phase 1 clinical study in which multiple drugs or drug combinations can be tested simultaneously, directly into a patient’s own tumor without toxicity associated with systemic drug delivery”, Klinghoffer reports.
In another research project, funded by the National Institute of Biomedical Imaging and Bioengineering (NIBIB) www.nibib.nih.gov, scientists have developed a microfluidic chip that can capture rare clusters of circulating tumor cells which hopefully will yield important new insights into how cancer spreads.
Circulating tumor cells (CTC) break away from a tumor and move through a cancer patient’s bloodstream Single CTCs are extremely rare but can take up residence in distant organs and spread cancer.
Even less common than single CTCs are small groups of CTCs or clusters. While the existence of CTC clusters have been known for more than 50 years, their prevalence in the blood as well as their role in metastasis has not been thoroughly investigated.
Researchers led by Mehmet Toner, PhD, Professor of Surgery at Massachusetts General Hospital www.massgeneral.org and Harvard-MIT Division of Health & Sciences Technology http://hst.mit.edu have developed a novel microfluidic chip that is specifically designed for the efficient capture of CTC clusters from whole unprocessed blood.
The new technology called the “Cluster-Chip” has been tested in a small trial of 60 patients with metastatic cancer. The chip was able to capture CTC clusters in 11 of 27 breast cancer patients, 6 of 20 melanoma patients, and 4 of 13 prostate patients. The large number of clusters found in the patient samples suggests a possibly greater role for clusters in the metastatic cascade.
Dr. Toner anticipates that the Cluster-Chip will play an important role in stimulating new research on CTC cluster biology. It could awaken the field to go after clusters and develop even better technologies to understand their biology in cancer metastasis.”
According to Roderic I. Pettigrew, PhD, M.D., NIBIB Director ‘The fact that some CTC clusters contain immune cells is of particular interest. Given the increasing number of cancer therapies that engage the immune system, the ability to monitor tumor immune cell interactions via the blood can be of great value.”