Massachusetts General Hospital Cancer Center
Recognized as one of the nation’s leading cancer care providers, the Massachusetts General Hospital (MGH) Cancer Center comprises 23 fully integrated, multidisciplinary clinical programs, as well as an extensive array of support and educational services. With a network of affiliations that extend throughout New England and the southeastern United States, the MGH Cancer Center is consistently ranked as one of the nation’s top 10 cancer centers by US News & World Report
The Center’s commitment to advancing oncology care by tailoring treatment options to the individual patient is apparent from the laboratory to the bedside. Physician investigators conduct nearly 400 clinical trials annually, and the Center is a founding member of a 7-member Harvard Medical School consortium designated by the National Cancer Institute as a comprehensive cancer center, forming what is the largest cancer research collaboration in the country and revolutionizing the future of cancer medicine with the novel treatments developed through this partnership. Furthermore, MGH nurses were the first in Massachusetts to achieve Magnet status from the American Nurses Credentialing Center in recognition of the hospital’s exceptional nursing care.
Two examples of the Center’s powerful synergy between laboratory scientists, bedside physicians, and nursing staff are its ground-breaking work with the CTC-chip and the genetic profiling initiative of the Molecular Pathology Translational Research Lab.
The CTC-Chip: A New Era of Cancer Research
It was 2008 when MGH Cancer Center scientists published 2 papers describing promising results for a new nanotechnology device that enables capture of circulating tumor cells (CTCs). Known as the CTCchip, the technology at long last provided the means to analyze these exceedingly rare, living solid-tumor cells in real time, and to unlock critical information with the potential to revolutionize the way cancers are detected, treated, and monitored.
Lecia V. Sequist, MD, MPH
“With the rapid emergence of highly personalized cancer care comes a pressing need for a thorough understanding of the genetic makeup of malignant tumors, and an equally clear understanding of what happens in those tumors over time,” said Lecia V. Sequist, MD, MPH, medical oncologist and co-lead author of The New England Journal of Medicine
article that first described the CTC-chip. “The CTC-chip is proving integral to achieving this understanding and applying what we learn to clinical practice,” Sequist said.
In its first incarnation the CTC-chip, developed by MGH Cancer Center researchers and BioMicroElectroMechanical Systems (BioMEMS) Resource Center scientists, was a business-card-size silicon chamber containing thousands of microfluidic antibody-coated posts designed to attract and enable capture of CTCs from small blood samples. A pilot study demonstrated its ability to not only detect CTCs, but also to reveal the genetic signature of lung tumors in patients with nonsmall cell lung cancer, identify candidates for targeted therapy, define prognostic and predictive measures, and measure treatment response.
These findings notwithstanding, the post-based chip proved impractical to manufacture for largescale clinical trials, prompting the development of a next-generation herringbone CTC-chip, explains Shannon L. Stott, PhD, research fellow and coinventor of the new chip. “In this herringbone version, which is now transparent, the posts have been replaced with grooves that create chaotic flow of blood as it travels through the device, allowing more interaction between the CTCs and the chip’s antibodycoated surface, and making large-scale manufacturing more practical and cost effective,” Stott said.
Shannon L. Stott, PhD
To date, the herringbone chip has been used in clinical studies designed to identify CTCs from patients with metastatic prostate, lung, pancreatic, colon, and breast cancers, and is enabling identification of mutations that help to indicate which patients are likely to benefit from targeted therapies.