Testing for Circulating Tumor Cells

Circulating Tumor Cells (CTCs)

CTCs are cancer cells which have broken away from the primary tumor and entered the blood stream where they circulate and have the potential to generate metastatic disease.  These cells can be isolated and identified and there is growing interest in their detection for the following purposes:

  1. detect early signs of a developing cancer,
  2. help to monitor existing cancers,
  3. produce an individual profile of which cancer drugs and which natural substances can be used to achieve the best treatment outcomes.

Cancer Stem Cells (CSCs)

Circulating CSCs represent a distinct subpopulation of CTCs that possess the tendency to cause metastatic disease.  As compared to non-aggressive CTCs, circulating CSCs may be capable of evading primary tumor treatment, while also hiding from the immune system, surviving in the circulating blood and subsequently forming metastases in distant organs.  Thus, circulating CSCs are characterized by their invasive characteristics and are potential therapeutic targets for preventing disease progression.

RGCC Tests

Research Genetics Cancer Center (RGCC) Group was established in 2004 by Dr. Ioannis Papasotiriou.  The company is a pioneering, innovative organization working in the fields of medical genetics and, in particular, cancer genetics, chemosensitivity and chemo-resistance testing and in Research and Development within the pharmaceutical industry via RGCC Pharma Ltd.  The company headquarters are in Switzerland, and the brand new, state-of-the art laboratories in Northern Greece are equipped with the most up-to-date technological, advanced and innovative equipment.

There are numerous new labs arriving on the CTC testing scene.  They measure various cancer markers and use various technologies, basically to detect and monitor CTC numbers.  None of the newer labs are doing sensitivity testing, so for now we are still using RGCC as it seems to give the best total information.

RGCC Group offers general assays for CTCs and for specific cancers, including breast, colorectal, prostate, malignant melanoma and sarcomas.  The test if performed from a simple blood sample and results are completed in 7-10 days.

Oncocount.  Provides information on the presence and the concentration of CTCs.  It enumerates only the progenitor cells that are relevant to potent relapse and recurrence of the disease.  (about $600)

Oncotrace.  Reports the number of CTC’s, any positive CSC’s, and the immunophenotype of these cells.  The most useful screening test.  This test should be ordered first and if positive one can then order the Onconomics panels.  RGCC must be notified by e-mail to continue with the Onconomics panel before the 9th day after receiving results. If one waits longer a new blood sample will be needed.  (about $850)

Oncotrail.  Provides information about the presence of CTCs and their concentration and immunophenotype for specific types of malignancies.  This test is a tailor-made test for specific type of malignancies such as breast cancer (Oncotrail for Breast), Prostate (Oncotrail for Prostate), Sarcoma etc.  This test includes only markers relevant for a specific type of malignancy which make the test a good tool for follow up control.  (about $825)

Onconomics.  This includes the chemosensitivity/chemoresistance assessment for cytotoxic drugs, monoclonal antibodies, and small molecules that inhibit specific targets eg. (TKI, etc.).  No natural substances tested.   (about $2000)

Sample Report Onconomics

Onconomics Extracts.  This test includes only the assessment of natural substances and plant extracts for any anticancer potency. No chemotherapeutic agents tested and no tumor suppressor genes tested.  (about $1800)

Sample Report Onconomics Extracts

Onconomics Plus.  This test is the Onconomics, above, and adds the assessment of natural substances and plant extracts for any anticancer potency.  The most complete and the most information for personal cancer care and support.  (about $3100)

Circulating Cell Numbers

Below the index of markers on the following tests:  Oncocount, Oncotrace, and Oncotrail you will find the below statement about index of cell number.

Index of circulating cells number: (If Over limit: Advanced or Progression of Disease, If Less than limit: Early disease or disease is responding to a treatment plan).

Breast cancer: < 5cells /7.5ml , Prostate cancer < 20cells/ml , Sarcoma: <15cells/6.5ml, Colon cancer: <5cells/ml, Lung cancer (Lc=0, r=0.99): <10cell/ml. All cancer types other than those listed above should be <5 cells/ml.

These numbers are the upper limits for these type cancers.  Meaning, the lower the number the less likely they will have a metastases or reoccurrence.  The only normal number is zero (0) cells found.  And after starting therapy you want to see the numbers decrease and the positive and phenotypes start going negative as well.

RGCC has performed over 1800 tests since 4/2004. From a purely clinical aspect I have come to the conclusion and explain our goals to the patient as follows:  my first goal is to get your CSC count below 5 cells/unit and the next goal is to get the numbers below 3 cells/unit.  I also let the patient know that the cell count may have been higher than the above limits at some time before we did the test.

Research links:

RGCC Group

Circulating tumor cells: a multifunctional biomarker

Circulating cancer stem cells: the importance to select

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