TUMORS SHED CELLS INTO THE BLOOD of patients with cancer, but researchers have long sought a reliable way to detect these rare cells. Now, however, investigators atMassachusetts GeneralHospitalinBostonreportsuccessful tests with a unique microchip-based device thatcanefficientlyandselectively separatecirculating tumorcells fromperipheral blood samples (Nagrath S et al. Nature. 2007;450[7173]:1235-1239). The technology has been used to identify these cells in the blood of patients with various types of metastatic cancer and to effectively monitor individuals’ responses to therapy. Ultimately, the inventors hope, the device will someday enable physicians to characterize and monitor cancer status in patients in a noninvasive way. While the presence of circulating cancer cells seems to correlate with prognosis in some studies, however, it remains to be seen whether the detection of these cells has any clinical benefit. Patients with metastatic cancer have as few as one circulating tumor cell per 10 hematologic cells in their blood. In previous work, researchers have used flow cytometry, immunomagnetic beads, high-throughput optical imaging systems, and fiber optic array scanning to detect these cells. However, in the work reported by the Boston-based investigators, the new chip technology is more streamlined and isolates greater numbers of viable cells, according to senior author Mehmet Toner, PhD, who is director of Massachusetts General Hospital’s BioMicroElectroMechanical Systems Resource Center. “The beauty of the technology is its simplicity—it uses whole blood with no preprocessing and it’s gentle on the cells,” Toner said. In addition, the device can handle large volumes of blood, unlike other techniques that are limited to microliter amounts of liquid. Other researchers note additional qualities of the device. “The data show that it’s far more sensitive than earlier technologies, and it purifies these rare circulating tumor cells, which is ex-
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