DATE: June 17th, 2015 TIME: 8am Pacific time, 11am Eastern time
Spatial heterogeneity of tumors has been identified within and between metastatic lesions and can be visualized with targeted PET imaging, biopsy IHC and microdissected-targeted NGS. Tissue biopsies can underestimate clonal and phenotypic differences between metastatic sites, and lack of single cell characterization can homogenize intra-tumoral heterogeneity. Additionally, acquired therapeutic resistance leads to temporal heterogeneity of tumors leading to the need for longitudinal tissue biopsies in some patients. Recently, large investments into liquid biopsies have employed the utilization of cfDNA to identify tumor mutations with known targets or are correlated with resistance to disease. However, utilization of cfDNA as a primary tool can underestimate intra-patient tumor heterogeneity and neglect the protein drivers of disease progression, including tyrosine kinase receptor amplification, loss of tumor suppressor function, epithelial plasticity. At Epic Sciences, we have developed a platform to characterize single circulating tumor cells (CTCs) for morphologic, protein and genomic targets at the single cell level and have applied the platform to thousands of samples from metastatic cancer patients. We will present data on the impact of morphology, protein chemistry and genomics of single CTCs in the context of contemporary unmet clinical needs in mCRPC. The impact of this clinical data suggests employment of a rational development of combination therapies to combat disease heterogeneity.