Cancer Management and Research (Jan 2018)

Detection of circulating tumor cells in liquid biopsy from Ewing sarcoma patients

  • Benini S,
  • Gamberi G,
  • Cocchi S,
  • Garbetta J,
  • Alberti L,
  • Righi A,
  • Gambarotti M,
  • Picci P,
  • Ferrari S

Journal volume & issue
Vol. Volume 10
pp. 49 – 60

Abstract

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Stefania Benini,1 Gabriella Gamberi,1,2 Stefania Cocchi,1 Jessica Garbetta,1 Laurent Alberti,3 Alberto Righi,1 Marco Gambarotti,1 Piero Picci,1 Stefano Ferrari4 1Department of Pathology, Rizzoli Institute, Bologna, 2Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy; 3Department of Pathology, Centre Léon Bérard, Lyon, France; 4Department of Chemotherapy, Rizzoli Institute, Bologna, Italy Background: Circulating tumor cells (CTCs) analysis is a promising new diagnostic field to estimate risk and monitor treatment efficacy, metastatic relapse, and progression in cancer patients. The study aim was to isolate and characterize CTCs in blood samples of Ewing sarcoma (ES) patients exploiting two main characteristics: CD99 expression and presence of chromosomal translocations.Materials and methods: The method isolated CTCs from peripheral blood (PB) of ES patients. Cell-surface CD99 was a useful marker for CTCs determined using immunomagnetic separation with microbeads and CD99 monoclonal antibody. We tested sensitivity and specificity by detecting CTCs in blood collected from healthy donors and randomly during therapy from 18 ES patients. Evidence of CTCs was confirmed by detection of specific molecular markers using quantitative and digital reverse transcription-polymerase chain reaction targeting EWSR1/FLI1 type 1 and type 2 or EWSR1/ETS-related gene transcripts type 1 and type 9e.Results: Feasibility of finding CTCs in PB of ES patients by immunoseparation with CD99 antibody and magnetic microbeads was demonstrated for the first time. At molecular analysis, three PB specimens tested positive for chimeric EWSR1/FLI1 type 2 and one PB for chimeric EWSR1/FLI1 type 2. CTCs detection was found above a limit of detection of 1 cell/mL of PB.Conclusion: CTCs in PB of ES patients can be identified by this method and in ES CTCs analysis can be used as a liquid biopsy approach for prognostic and predictive purposes. The potential clinical implications of CTCs in PB samples detected by the platform for CTC isolation with molecular confirmation during therapy require further evaluation. Keywords: circulating tumor cells, anti-CD99 antibody, magnetic beads, Ewing sarcoma, immunoseparation, liquid biopsy 

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