OS related to CTC response (response: 30% decline) 4 weeks 8 weeks 12 weeks

Transcription

1 OS related to CTC response (response: 30% decline) 4 weeks 8 weeks 12 weeks 20

2 CTC characterization (DNA, RNA, proteins) - Therapeutic targets - Resistance mechanisms

3 Detection of therapeutic targets on CTC: HER2 oncogene in breast cancer A Composite CK DAPI CD45 HER2 CTC without HER2 gene amplification Red: CK ICC Green: HER2 Red: Cen17 DETECT-III study: Anti-HER2 therapy (lapatinib) in metastatic breast cancer FISH FISH CTC 0 patients with HER2-negative primary tumors and HER2-positive CTC CTC with HER2 gene amplification 3+ B Composite CK DAPI CD45 HER2 C CB11 A0485 FISH MCF-7 0 SK-BR-3 BT20 1+ T47D MDA- MB-453 SK-BR-3 BT Discordance between HER2 status of primary tumor and CTCs in metastatic patients Riethdorf/Pantel et al., Clinical Cancer Res Fehm/Pantel et al., Breast Cancer Res Treat Ignatiadis/Sotiriou et al, PlosONE, Ignatiadis/Pantel et al, SABCS, 2011

4 Genomic Characterization of single CTC CTC detection CTC isolation WGA + - Mutation analysis - CGH (conv./array) - NextGen Sequencing CTC Capillary CTC

5 Individual Cell Sorting with DEPArray image pop-up from scatter plot multiple recoveries of cells 2010 Silicon Biosystems spa

6 Cell-free ctdna/mirna and exosomes as Blood-Based Biomarkers Schwarzenbach, Pantel et al., Nature Rev. Cancer 2011; Nature Rev. Clin. Oncol. 2014; Pantel et al., Nature Med. 2013; Speicher & Pantel, Nature Biotech. 2014; Joosse & Pantel, Cancer Cell, 2015; Alix-Panabieres & Pantel, Cancer Discovery, 2016 Cancer-ID is a project funded by the Innovative Medicines Initiative Joint Undertaking (IMI JU).

7 2013 How can the analysis of DNA fragments released from apoptotic/necrotic cells reveal important information on resistant tumor cells surviving therapy? (Schwarzenbach, Hoon, Pantel, Nat. Rev. Cancer 2011; Pantel et al., Nature Med., 2013; Speicher & Pantel, Nat. Biotech. 2014)

8 Comparative analysis of CTCs and ctdna in breast cancer 1. Progressive disease with increasing liver metastases and ascites no chemot ctdna levels may not always reflect disease progression in 2. Excessive numbers of CTCs (~50.000/7.5 ml) in three blood samples; each with multiple homogeneous copy number changes and mutations in CTCs CTCs CTC analyses are not restricted to dying cancer cells and provide complementary information. 3. However, very low concentration of ctdna fragments at each measurement ctdna all cancer patients. Heidary, Speicher, Pantel et al, Breast Cancer Res. 2014

9 Functional studies on CTCs

10 2013 Potential Metastasis-initiating Cells: EPCAM +, CD44 +, CD47 + and cmet + Limitation: Immunodeficient host!

11

12 Cell line from human circulating colon cancer cells - Expression profile Mesenchymal Epithelial Stem cell Stem cell ITB seminar Cayrefourcq et al., Cancer Research 2015

13 Copy number analysis of single cells - Colorectal cancer patient K + DAPI + CD45 - Cayrefourcq et al. (2015) Cancer Res German Cancer Congress 2016 Simon Joosse (s.joosse@uke.de)

14 2016 CTCs and ctdna provide complementary information

15 EFPIA Academic institutions CANCER-ID EU Konsortium Scientific Managment: Klaus Pantel, UKE (Leon Terstappen) Coordination: Thomas Schlange, BAYER (Barbara Baggiani) Prof. Klaus Pantel Clinical sites 32 partners: 6 EFPIA companies (lead Bayer, colead Menarini) 17 academic/clinical sites 6 SMEs 2 non-profit organizations 1 non-sme/non-efpia Non-profit organizations Blood-based Diagnostic in Lung and Breast Cancer (CTCs, ctdna, cfmirna & exosomes) Prof. Leon Terstappen 37 EU Partners (Academic institutions, non- SMEs profit organisations & companies) Non-EFPIA/ non-sme Page 34 CANCER-ID evaluation hearing Brussels- Oct 7th 2014

16 Key Deliverables of the Full Project Establish criteria for evaluation of different CTC isolation technologies; Sample collection and developing storage protocols (SOPs) allowing shipment and bio banking for collection and analysis at different research sites; Comparison of methods for the molecular analysis of CTCs with respect to correlation with primary tumor material, clinical outcome, treatment response and ctdna status of patients; Evaluation of different ctdna/mirna analysis methodologies in terms of compatibility with sample collection and storage as well as reproducibility in clinical samples; Development of database and data analysis infrastructure for correlative studies of CTCs, ctdnas and mirnas in clinical samples; Development of technologies for blood-based companion diagnostics ideally up to proof of clinical utility supporting regulatory approval. Cancer-ID is a project funded by the Innovative Medicines Initiative Joint Undertaking (IMI JU). 35

17 CANCER-ID PERT Chart Cancer-ID is a project funded by the Innovative Medicines Initiative Joint Undertaking (IMI JU). 36

18 Micrometastasis Research Network at UCCH/UKE Institut für Klinische Chemie Institut für Anatomie II Klinik und Poliklinik für Gynäkologie Klinik und Poliklinik für Viszeralchirurgie I. Medizinische Klinik und Poliklinik Institut für Rechtsmedizin Institut für Tumorbiologie Klinik und Poliklinik für Neurochirurgie Labor für Strahlenbiologie und -onkologie Institut für Biochemie und Molekularbiologie II. Medizinische Klinik und Poliklinik Klinik und Poliklinik für Urologie/Martiniklinik Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie

19 Center of Experimental Medicine Institute of Tumor Biology - Klaus Pantel ERC Advanced Investigator Grant DISSECT ( ) Grant Support: DFG Sabine Riethdorf, Sonja Mader BMBF Tobias Gorges, Andra Kuske, Claudia Hille EU / ERC Heidi Schwarzenbach, Volker Assmann Dt. Krebshilfe Harriet Wikman, Stefan Werner, Annkathrin Hanssen Sander-Stiftung Simon Joosse, Anna Babayan Roggenbuck-Stiftung Kai Bartkowiak, Natalia Bednarz-Koll