The next step is to be able to molecular characterize the CTCs (Her2, ER/PR, other receptors, mutations) and guide treatment strategies realtime and accelerate clinical trials.
This sentence gave me pause: "Of those, 15 per cent experienced a cancer relapse and 10 per cent died during the study period" in 5 years study period 2005-2010. 5 year mortality rate of about 66% among these early breast cancer patients with 1 + CTCs. This is at MD Anderson.
"For women with three or more circulating tumour cells in their blood sample, the outcomes were much worse: 31 per cent died or experienced a relapse."
This is why the research for MBC cure needs to accelerate. 20 years, the improvement in MBC mortality rate has gone from 97% to 66%. MBC is not "chronic" like AIDS or diabetes. AIDS or diabetes patients can expect to live a full life span. MBC is a killer with no cure. and no early stage patient is really cured till MBC has a cure.
CTC test is not without problems.
CTC test needs special tubes and needs mixing the blood carefully after blood draw. Also it needs to be run 2-3 days after the blood draw.
Also, CTC has high false-negative rate. ie, only a portion of metastatic patients get positive CTCs. The next generation of CTC test hopefully will lower that false negative rate, and become more accurate.
But for fast clinical trials, CTC can be an useful tool. Say you take only patients with 5+ CTCs, gave them experimental medicine and see whether the CTC drastically drops and stay dropped. Patient commitment: a course of experimental medication. Researcher gets results in a few days/weeks can go on to the next iteration of experimentation with dosage or drug design. Cost would be much less than current clinical trial cost design. There will be more drug companies testing more drug candidate for cheaper. End result: the cure.
I'm sure the doctors would say "this is not ready for prime time". Doctors can be as cautious, caution being the intersection of lawsuit and scholarship cultures. But hey, 10 years later when it's ready for prime time, a lot of patients would have died for want of the cure, and MBC mortality rate would drop from 66% to 50%?
I'm sure the doctors would say "this is not ready for prime time". Doctors can be as cautious, caution being the intersection of lawsuit and scholarship cultures. But hey, 10 years later when it's ready for prime time, a lot of patients would have died for want of the cure, and MBC mortality rate would drop from 66% to 50%?
Dying patients do not wait for prime time.
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