Observations from the World Circulating Tumor Cell (CTC) Summit

The World Circulating Tumor Cell Summit occurred in Boston, Massachusetts from November 30 to December 1, 2010. My colleague Shane Climie and I attended, and here we share the top 10 ideas we took away from this important meeting, which focused on exploring the near-term commercial potential of many of the exciting new CTC technologies. Presenters and attendees at the meeting also discussed how CTCs might be utilized both in clinical trials and in clinical practice.

While the research community is still seeking to determine exactly what a CTC is, efforts to detect, isolate and characterize CTCs continue to increase.

Our Top 10 Takeaways:

1. Pharmaceutical companies, diagnostics companies and venture capital firms are showing accelerating interest in CTCs.
2. Several interesting new platforms are close to market as this is definitely a “hot” space with commercial potential. Some companies will launch their platforms imminently by providing services in their own (CLIA) labs.
3. New assays in this space will have analytical performance challenges (e.g., the coefficients of variation (CV) are high).
4. Many preanalytical issues remain to be resolved, such as how samples should be collected, prepared, and shipped as well as how long they can be stored.
5. There is a general lack of consensus among researchers and industry regarding how to best use CTC information in clinical decision-making. We believe that this will be reduced over time as experience with the new tools accumulates.
6. Currently, there appears to be growing interest in the characterization of CTCs.  Many current applications of CTCs (mostly prognosis) relied entirely on enumeration. However, characterization of CTCs may enable several other applications, including prediction and monitoring of drug response and patient selection.
7. Researchers are showing particular interest in Her2 status of CTCs in breast cancer and EMT in lung and other cancers. In order to compare platforms, a standardized definition of what a CTC is must be established.
8. Although a standardized definition of CTC is needed, any such definition is likely to change over time as the technology evolves to enable the isolation of other CTC-like rare cells that are found in the circulation of cancer patients.
9. The CTC population is definitely very heterogeneous: We do not yet know what component is most important in cancer metastasis. We therefore envisage a “differential count” or segmentation of the CTC population, analogous to a differential count of the circulating white blood cell population.
10. We believe that the measurement of some flavor of CTCs will be routine in cancer monitoring in two to five years.

There is no doubt that the cancer diagnostic landscape is changing rapidly, and we are fascinated with the role that CTCs may play in this space. Is this a trend that you are monitoring? How may it impact your business? Do you have other observations about CTCs that you would add to the list above? Please share your comments here.

About the Author: Ken Walz has spent more than 20 years in the biotech and medical device industries in business development and finance roles and has broad experience in the structuring and negotiation of collaborative arrangements, strategy development, and financial planning and analysis.