title: Impact of label-free technologies in head and neck cancer circulating tumour cells.
abstract: The ability to identify high risk head and neck cancer (HNC) patients with disseminated disease prior to presenting with clinically detectable metastases holds remarkable potential. A fraction of circulating tumour cells (CTCs) are invasive cancer cells which mediate metastasis by intravasation, survival and extravasation from the blood stream to metastatic sites. CTCs have been cleared by the FDA for use as surrogate markers of overall survival and progression free survival for breast, prostate and colorectal cancers using the CellSearch® system. However, the clinical significance of CTCs in head and neck cancer patients has yet to be determined. There has been a significant shift in CTC enrichment platforms, away from exclusively single marker selection, to epitope-independent systems.
  
  
  
  The aim of this study was to screen advanced stage HNC patients by the CellSearch® platform and utilise two other epitope-independent approaches, ScreenCell® (microfiltration device) and RosetteSep™ (negative enrichment), to determine how a shift to such methodologies would enable CTC enrichment and detection.
  
  
  
  In advanced stage HNC patients, single CTCs were detected in 8/43 (18.6%) on CellSearch®, 13/28 (46.4%) on ScreenCell® and 16/25 (64.0%) by RosetteSep™ (the latter could also detect CTC clusters). Notably, in patients with suspicious lung nodules, too small to biopsy, CTCs were found upon presentation. Moreover, CTCs were readily detected in advanced stage HNC patients.
  
  
  
  The epitope-independent platforms detected higher CTC numbers and clusters. Further studies are needed to ascertain whether CTCs can be used as independent prognostic markers for HNCs.
authors.affiliation: The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: Arutha
authors.initials: A
authors.lastname: Kulasinghe
authors.affiliation: School of Medicine, University of Queensland, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia.
authors.forename: Liz
authors.initials: L
authors.lastname: Kenny
authors.affiliation: Department of Otolaryngology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Perry
authors.affiliation: Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Thiery
authors.affiliation: Australian Prostate Cancer Research Centre-Queensland, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
authors.forename: Lidija
authors.initials: L
authors.lastname: Jovanovic
authors.affiliation: Australian Prostate Cancer Research Centre-Queensland, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.|Department of Urology, Princess Alexandra Hospital, Wolloongabba, Queensland, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Vela
authors.affiliation: Australian Prostate Cancer Research Centre-Queensland, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
authors.forename: Colleen
authors.initials: C
authors.lastname: Nelson
authors.affiliation: The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: Chamindie
authors.initials: C
authors.lastname: Punyadeera
mesh_terms: D000328:Adult; D000368:Aged; D045744:Cell Line, Tumor; D000939:Epitopes; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D011379:Prognosis
chemical_list: D000939:Epitopes
keywords: circulating tumour cells; head and neck cancers; label free capture; metastasis; CellSearch®