Tumor cell counting gives a very good overview of how the tumor is behaving. If the CTC numbers increases, one can assume renewed activity, if they remain the same or decrease over time, then this is generally a good sign. Therefore, surveillance or monitoring of the cell count every 4-6 months is recommended to detect new tumor activity in time.
Tumor cell-counting direkt in patient blood
Tumor cell counting using maintrac works on solid tumors (carcinomas) that are epithelial in origin. These are about 90% of all tumor diseases. The cells of these carcinomas have one thing in common, they carry the so-called human epithelial antigen protein on the cell surface. This antigen can be labeled with the specific EpCam antibody and thus the number of cells can be accurately counted.
A patient’s blood is processed in the laboratory WITHOUT cell loss and the tumor cells are labeled with Epcam antibodies. The cell count can then be determined quantitatively. With this value, the patient can now be monitored over the coming weeks, months and years. When the cell count remains the same or decreases – it is a good sign. However if it increases significantly over time, this indicates renewed tumor activity and the therapy should be adjusted.
We find from 50-5000,000 tumor cells (CTCs) per milliliter in the patient’s blood. The value is of less importance, what counts is the progression of the cell count. Therefore, the cell count should always be determined before chemotherapy. It fluctuates very strongly during therapy. At the end of chemo, a kind of baseline value is given for the following months. We still find CTCs in almost every patient, but most of the cells are just “dormant” cells that cannot form new tumors.
Monitoring of Cancer Diseases
Maintrac is optimized to monitor cancer therapies and therefore offers a large time advantage over imaging techniques. Studies have shown that about 3 consecutive increases up to 3-fold indicate new tumor activity. It is only a few months later that the tumor has grown large enough to be detected by imaging techniques (CT, MRI, PET). A stable or decreasing cell count, on the other hand, is a very good sign (see link to publications).
Tumor cell counting with maintrac – how does it works?
maintrac® can help to find an individual, personalized and effective therapy for the single patient. And the therapy success can be monitored over time. To perform a tumor cell count, the physician draws 15 ml EDTA blood and send it to our Medical Laboratory. You or your physician can order appropriate collection kits from us.
For which type of therapy can maintrac be used?
Tumor cell counting can be used as therapy monitoring in neoadjuvant, adjuvant and hormone or maintenance therapy. maintrac® can also make a special contribution to therapy in “watch and wait” situations , especially in prostate cancer.
Even if the CTCs in the blood have completely disappeared with a good response, the therapy should always be completed. There could still be cells hidden in the tissue that may re-enter the blood and only be eliminated during the course of further therapy.
Changes of tumor cells
Tumor cells are often altered by therapy and may proliferate again after completion of therapy. Therefore, the success of the therapy should be repeatedly monitored by tumor cell counting.
Important. To understand the difference to other CTC determination methods:
- maintrac does not isolate or extract cells, and thus always has a true quantitative reference to the blood volume used for diagnosis. Maintrac is currently probably the most sensitive CTC detection and characterization system in the world.
- Our attempts to isolate or extract cells with other methods have unfortunately always resulted in large cell losses (often well over 90%). That is why isolation or extraction methods will not work and are, in our experience, not suitable for monitoring disease progression and cannot make reliable statements about possible drug tests.
- Drug testing: Maintrac makes a clear distinction between dead and live CTCs. Therefore, together with the quantitative approach, different medications can be tested on the cells. A mortality rate of the cells can be determined and thus a prediction on the expected effectiveness of the treatment can be made.
- Cancer is a very individual disease for which there are no exact threshold values for cell numbers. Therefore, maintrac works with cell count histories that are comparable to each other. We have patients with high, stable cell counts who do very well over many years. However, we also have patients who, despite low cell counts but a corresponding increase in cell count, unfortunately develop metastases very quickly.
- Publications: maintrac is one of the best studied systems for tumor cell diagnostics with more than 130 publications and > 30 clinical trials so far.