title: A pilot study to explore circulating tumour cells in pancreatic cancer as a novel biomarker.
abstract: BACKGROUND
  Obtaining tissue for pancreatic carcinoma diagnosis and biomarker assessment to aid drug development is challenging. Circulating tumour cells (CTCs) may represent a potential biomarker to address these unmet needs. We compared prospectively the utility of two platforms for CTC enumeration and characterisation in pancreatic cancer patients in a pilot exploratory study.
  
  
  METHODS
  Blood samples were obtained prospectively from 54 consenting patients and analysed by CellSearch and isolation by size of epithelial tumour cells (ISET). CellSearch exploits immunomagnetic capture of CTCs-expressing epithelial markers, whereas ISET is a marker independent, blood filtration device. Circulating tumour cell expression of epithelial and mesenchymal markers was assessed to explore any discrepancy in CTC number between the two platforms.
  
  
  RESULTS
  ISET detected CTCs in more patients than CellSearch (93% vs 40%) and in higher numbers (median CTCs/7.5 ml, 9 (range 0-240) vs 0 (range 0-144)). Heterogeneity observed for epithelial cell adhesion molecule, pan-cytokeratin (CK), E-Cadherin, Vimentin and CK 7 expression in CTCs may account for discrepancy in CTC number between platforms.
  
  
  CONCLUSIONS
  ISET detects more CTCs than CellSearch and offers flexible CTC characterisation with potential to investigate CTC biology and develop biomarkers for pancreatic cancer patient management.
authors.affiliation: Clinical and Experimental Pharmacology Group, Paterson Institute for Cancer Research, Wilmslow Road, Manchester M20 4BX, UK.
authors.forename: L
authors.initials: L
authors.lastname: Khoja
authors.forename: A
authors.initials: A
authors.lastname: Backen
authors.forename: R
authors.initials: R
authors.lastname: Sloane
authors.forename: L
authors.initials: L
authors.lastname: Menasce
authors.forename: D
authors.initials: D
authors.lastname: Ryder
authors.forename: M
authors.initials: M
authors.lastname: Krebs
authors.forename: R
authors.initials: R
authors.lastname: Board
authors.forename: G
authors.initials: G
authors.lastname: Clack
authors.forename: A
authors.initials: A
authors.lastname: Hughes
authors.forename: F
authors.initials: F
authors.lastname: Blackhall
authors.forename: J W
authors.initials: JW
authors.lastname: Valle
authors.forename: C
authors.initials: C
authors.lastname: Dive
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor