Epithelial Mesenchymal Plasticity (EMP) in circulating tumour cells: A window into metastatic breast cancer biology

In breast cancer patients whose tumour has spread to other parts of the body (metastasised), the presence of cancer cells in the blood (known as circulating tumour cells or CTCs) has been shown to predict for future relapse and death from breast cancer. Whereas current clinical trials are measuring the absence or presence of CTCs, we believe that the individual analysis of specific cancer markers will be more informative. We have developed a set of procedures to capture CTCs from blood and perform simultaneous analysis for multiple markers within each sample (blood) collection. We propose to perform molecular analysis of CTCs throughout the course of treatment in multiple blood collections from each of 15 patients with metastatic breast cancer. For controls, 10 bleeds from normal healthy volunteers (NHV) will be analysed as well. While this is primarily a pilot study to test our technologies, the detailed molecular analysis of CTCs may eventually allow us to better (i) predict whether a patient is likely to respond to a given therapy, (ii) determine already during treatment whether a patient is responding, and (iii) to understand when a therapy stops working.