The authors would like to thank the MSKCC Tissue Procurement Service Team (TPS), specifically, Maria Corazon Mariano, Priscilla McNeil, Anas Idelbi, Daniel Navarrete and Katrina Allen, in all of their efforts in the successful pursuit of this project and funding from the following sources: 5 R21 CA158609-02 and the Conquer Cancer Foundation and the Breast Cancer Research Foundation. In addition, the authors would like to thank Eric Cottington PhD, Vice President of the Office of Research and Project Administration, the Office of Technology Development, Research Outreach and Compliance and RTM Information Systems Support, in the support of the submission of this manuscript.

NOTA: approvvigionamento dei tessuti del paziente è stato autorizzato attraverso la revisione bordo istituzionalmente (IRB) -approvato Biospecimen e protocolli clinici (numeri di protocollo 09-121 e 11-041, rispettivamente) al Memorial Sloan Kettering Cancer Center. Procurement 1 Tissue <ol><li> Approvvigionamento di paziente tumore primario / metastasi NOTA: Fino ad oggi, questo protocollo è stata eseguita su pancreatiche, gastriche e tipi di tumore al seno chirurgicamente rimosso, così come, metastasi linfoma. <ol><li> Dirigere il team chirurgico di consegnare il campione di corriere o sistema a tubo pneumatico per il reparto di Patologia in borsa tenuta esemplare di plastica ben chiuso e sterile nel contenitore a prova di fuoriuscita sterile. Dirigere la squadra chirurgica per trasportare il campione allo stato fresco senza formalina o fissante. </li><li> Dirigere l&#39;assistente patologo o patologo per raccogliere il campione fresco con tecnica sterile, che includes uso di guanti e strumenti sterili sotto una cappa a flusso laminare. </li><li> Registrare il tempo di raccolta del campione procurati, che viene tenuto rigorosamente sotto 30 minuti dal completamento della procedura chirurgica. Prendendo in considerazione gli effetti di ischemia fredda, non prelevare campioni da campioni resecati con un tempo di ischemia fredda&gt; 30 min 18. </li><li> Dirigere il personale del Dipartimento di Patologia per rimuovere un campione del tumore primario di circa 0,5 centimetri 3-1,0 cm 3 in una cappa a flusso laminare per mantenere un ambiente sterile. Quando possibile, scegliere il tessuto tumorale dalla periferia della lesione indice per evitare possibili necrosi centrale (morte cellulare) frank. NOTA: Il tessuto necrotico può essere grossolanamente riconoscibile per uno dei seguenti criteri: perdita di colore o pallore del tessuto; perdita di forza in cui il tessuto necrotico è morbido e friabile; una demarcazione netta tra il tessuto necrotico e vitale. </li><li> Dirigere il pathologist o assistente patologo per fornire tessuti periferici che è in eccesso (scarti chirurgica) dopo il prelievo immediato del tumore per la valutazione diagnostica. Porre il campione in un tubo da centrifuga da 15 ml sterile contenente circa 5 ml di supporti essenziale minimo (MEM) contenente 1% antibiotici (penicillina e streptomicina). </li><li> Se disponibile (ad esempio, linfonodi ascellari di coda di campione mastectomia), procurarsi un grossolanamente positivi esemplare linfonodali associato della stessa dimensione (0,5 centimetri 3-1,0 cm 3) e confrontare la risposta ai farmaci del tumore primario. Come il campione del tumore primario, posizionare il campione associati linfonodi in un tubo da centrifuga da 15 ml sterile contenente circa 5 ml di supporto essenziale minimo (MEM) contenente 1% antibiotici (penicillina e streptomicina). </li><li> Se la dimensione dei permessi campioni chirurgici (ad esempio, campioni mastectomia), rimuovere (distante da tumore primario) di un campione di tessuto normale (cioè,normale / parenchima denso fibroso seno) e posto in una provetta da centrifuga conica da 15 ml sterile contenente circa 5 ml di supporti minimi essenziali (MEM) contenenti 1% antibiotici solo a scopo di trasferimento. In seguito trasferimento alle strutture di laboratorio, di trasferire il campione &#39;normale&#39; per un esageratamente, congelare &#39;scatto&#39; e conservare in un freezer -80 ° C per le analisi molecolari futuri. </li><li> Mettere tutti i campioni su ghiaccio bagnato e trasportare immediatamente allo spazio laboratorio per il sezionamento ex vivo tessuto fresco. Non tratto il campione normale, ma piuttosto conservare in un freezer -80 ° C per le analisi molecolari futuri. Trasferire una parte del tumore primitivo e metastasi associato ad una esageratamente, congelare &#39;scatto&#39; e conservare in freezer -80 ° C per le analisi molecolari futuri. </li></ol></li><li> Approvvigionamento di tessuto da studi clinici (ad esempio, centrali opzionale biopsie (CNB)) NOTA BENE: Otteniamo tessuti tumorali da pazientiiscritti ai protocolli clinici che danno il loro consenso a sottoporsi ad un CNB di una metastasi tumorale accessibili prima dell&#39;inizio della terapia. CNB, ad oggi, sono stati effettuati su pazienti con mammella, linfoma della zona marginale, linfoma a cellule del mantello, paraganglioma metastatico, cervice (cellule squamose) e tumori ovarici. <ol><li> Disporre di personale clinici di Radiologia Interventistica o servizio competente di eseguire un pre-trattamento nucleo ago biopsia e posizionare il campione in un 15 ml sterile provetta da centrifuga conica contenente circa 5 ml di supporti essenziale minimo (MEM) contenente 1% antibiotici (penicillina e streptomicina). </li><li> Posizionare il campione di biopsia su ghiaccio bagnato e trasportare immediatamente allo spazio laboratorio per il sezionamento ex vivo tessuto fresco. </li></ol></li></ol> 2 Preparazione dei materiali per le impostazioni sezionamento e vibratome <ol><li> Preparazione dei materiali per il sezionamento <ol><li> Fare una soluzione di agarosio al 4% con l&#39;aggiunta di 4 g di agasalito a 100 ml di PBS. Autoclave (Impostazioni ciclo: liquidi, 121 ° C, 30 min, a 15 libbre per pollice quadrato) la soluzione prima del primo utilizzo. Per gli usi successivi, posizionare l&#39;agarosio 4% in un forno a microonde per liquefare (Alto calore per intervalli di 30 sec) prima di ogni utilizzo e raffreddare adeguatamente a ~ 25 ° C (cioè, caldo al tatto), consapevoli che agarosio solidifica a temperatura ambiente. </li><li> Utilizzare l&#39;agarosio 4% come un supporto di tessuto embedding non permanente. Quando l&#39;agarosio 4% si è raffreddato a sufficienza ed è ancora in uno stato liquido, con una pinza sterile posizionare il campione di tessuto in uno stampo embedding e versare il agarosio 4%. </li><li> Posizionare il campione di tessuto stretti (~ 2 mm di distanza), ma non direttamente sulla parete superficie di taglio dello stampo embedding. L&#39;agarosio 4% inizierà a solidificarsi in fretta, quindi opportunamente posizionare il campione di tessuto in fretta. Durante il sezionamento, mantenere l&#39;agarosio 4% in un bagno d&#39;acqua a 55 ° C per mantenere in soluzione. </li><li> Per una piastra a 24 pozzetti per l&#39;analisi di sezione, aggiungere 1 ml of multimediale completo (ad esempio, MEM + 10% di siero fetale bovino + 1% antibiotici) in ciascun pozzetto. Mantenere la piastra a 24 pozzetti a temperatura ambiente (~ 25 ° C) per tutta la durata di sezionamento. </li></ol></li><li> Preparazione delle impostazioni vibratome <ol><li> Utilizzando il microtomo vibrante, impostare la velocità con cui la lama si avvicina il campione [0 (0,00 mm / sec) a 10 (2,5 mm / sec)] e la frequenza della lama [0 (0 Hz) a 10 (100 Hz) ]. Regolare le impostazioni in base alla consistenza del tessuto (ad esempio, densità / consistenza). </li><li> Per un tumore mammario primario del carcinoma duttale invasivo, regolare le impostazioni a 6 e 3, la velocità e la frequenza rispettivamente. Per tessuto tumorale meno denso / ditta, diminuire la velocità e aumentare la frequenza di conseguenza. </li><li> Impostare lo spessore di taglio entro i limiti dello strumento (1-999 micron). Per queste analisi, impostare lo spessore della sezione a 200 micron. </li><li> Montare il campione agarosio-embedded utilizzando un sottile strato di adesivo liquido sul tha disco dei campionit è immerso in un serbatoio di media che è racchiuso nel ghiaccio bagnato. </li></ol></li></ol> 3 Tissue sezionamento, trattamento e analisi <ol><li> Rimuovere le sezioni di precisione-affettato subito dopo il sezionamento con pinza sterile e posto in un piatto multi-bene con 1 ml di completo supporto. Quando le sezioni sono acquisite sufficienti per la risposta e le analisi correlative, posizionare la piastra multi-bene per la risposta al trattamento in un tessuto culturale incubatore fissato a condizioni di coltura dei tessuti normali. </li><li> Prendere più sezioni di controllo che fermalibri sezioni trattate nel tentativo di confermare la risposta dose-dipendente al contrario di manufatti in coltura. Eseguire tessuto sezionamento rapidamente (~ 30 - 40 minuti), ben al di eventuali effetti negativi del freddo tempo ischemico (~ 2 - 4 ore) 18. Eseguire il trattamento delle sezioni solo dopo un periodo di acclimatazione 1 ora. </li><li> Dopo il periodo di acclimatazione 1 ora, aggiungere dosi crescenti (terapeuticamente rilevanti; <em.&gt; Ad esempio, 0 - 10 micron) concentrazioni di farmaco alle sezioni e la casa in condizioni di coltura di tessuti standard per il periodo di trattamento. Per questo studio, utilizzare i periodi di valutazione hr 24 e / o 48. Tuttavia, il controllo (solo veicolo) sezioni di tessuto rimarranno vitali, come testato in questo studio, per periodi fino al periodi di valutazione 96 hr. </li><li> Dopo il trattamento, rimuovere tutte le sezioni in condizioni sterili e formalina-fix posizionando la sezione di tessuto in una provetta contenente sia il 10% formalina tamponata e posto a RT O / N o in una provetta contenente 4% paraformaldeide (diluito 16% paraformaldeide da un flaconcino con PBS per una concentrazione finale di 4%) e posto a temperatura ambiente per 2 ore. <ol><li> Fissare sezioni di tessuto di grandi dimensioni (ad es., ~ 6 mm x 4 mm) 200 micron di spessore in 10% formalina tamponata O / N a RT. Fissare sezioni più piccole (ad es. 1 mm x 1 mm) 200 micron di spessore in paraformaldeide al 4% per 2 ore a temperatura ambiente. NOTA: Per una penetrazione efficace del fissativo del volume di fixative opportuno 20X il volume del tessuto. Dato che il presente protocollo si traduce in dimensioni estremamente piccole di tessuto (ad esempio 6 mm 3 di tessuto = 6 ml di volume), per la garanzia di un uso corretto fissaggio 1 ml di fissativo per tutte le dimensioni del tessuto. </li><li> Dopo fissazione hanno i campioni di tessuto incluso in paraffina da parte del personale del Dipartimento di Patologia. Sezione esemplare blocchi di paraffina su vetrini caricati per essere ematossilina e eosina macchiato e valutati immunoistochimica (ad esempio, apoptosi). </li></ol></li></ol>

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No conflicts of interest disclosed.

Biologi cancro devono affrontare sfide significative nel tentativo di sviluppare efficaci strategie terapeutiche. Test farmaci in sviluppo su linee cellulari di cancro stabilite non può riflettere con precisione in risposta vivo e in vivo su modelli PDX sono laborioso e molto costoso. Considerato quanto sopra, l&#39;applicazione di tecniche ex vivo di paziente primaria tumori 14, 15 è ora posizionato accanto alla analisi molecolare di consolidate linee cellulari tumorali ...

Lo sviluppo di terapie efficaci cancro ha dimostrato di essere estremamente impegnativo. Linee cellulari tumorali e espianti tumorali - così come xenotrapianti sono stati utilizzati nella ricerca sul cancro per oltre mezzo secolo 1,2,3. Ad oggi, l&#39;analisi molecolare della sensibilità di droga e resistenza in entrambe le linee di cellule di cancro affermati e xenotrapianti di derivazione paziente (PDX) è indispensabile. Tuttavia, i test di composti in linee cellulari di cancro stabiliti spesso non è predittivo di efficacia in vivo, e corrispondenti studi in vivo negli animali, soprattutto nei modelli PDX, è molto costoso e richiede tempo. I limiti di questi sistemi modello, vale a dire l&#39;impossibilità di informare l&#39;influenza del microambiente nativo nella progressione tumorale e la risposta alle strategie terapeutiche, ha portato il campo di ricerca per sviluppare metodi aggiuntivi per complimentarmi con queste analisi. Di recente, accresciuta attenzione viene rivolta verso ex vivo analisi di tum pazienteo espianti 4, 5 a causa della maggiore comprensione che il cancro risposta terapeutica non è esclusiva alla composizione molecolare intrinseca delle cellule tumorali, ma piuttosto è fortemente influenzato dal microambiente delle cellule tumorali 6, 7, una caratteristica che non può essere riassunta con metodi di coltura tradizionali e / o PDX. ex vivo analisi nel contesto di cui sopra (ad esempio., influenza adiacente tumorale circostante microambiente cellulare) implica la valutazione delle sezioni tumore / metastasi primarie vitali, piuttosto che ex vivo analisi degli isolati cellulari 8, 9. Riportiamo qui su una tecnica ex vivo (ad esempio., Sezioni di precisione-fette fresche di tessuto) di entrambi i tumori primari del paziente e metastasi associate (ad esempio, linfonodi) che segnala fedelmente alla risposta (IC50), gli effetti off-target e consente molecolare analisi dei meccanismi di resistenza e di feedback. Inoltre, l&#39;analisi correlativa di therapeUTIC sensibilità / resistenza contro biomarker e profilo di espressione genica può essere eseguita in uno sforzo per identificare i pazienti più probabilità di rispondere al farmaco sperimentale di interesse (ad esempio., la risposta alle alte farmaco corrisponde paziente con particolare profilo biologico). Applicazione della tecnica ex vivo e la valutazione in modo multi-parametro è movimento verso la selezione dei pazienti e il miglioramento complessivo dei risultati clinici. Trattamento ex vivo analisi di risposta potrebbe diventare uno strumento standard per lo sviluppo preclinico e clinico di terapie del cancro ed è immaginato come un passo verso un approccio di medicina personalizzata nelle strategie di sviluppo terapeutiche.

<table border="0" cellpadding="0" cellspacing="0" width="598">
	<tbody>
		<tr height="43">
			<td height="43" style="height:43px;width:216px;">Name of Material/ Equipment</td>
			<td style="width:96px;">Company</td>
			<td style="width:119px;">Catalog Number</td>
			<td style="width:167px;">Comments/Description</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Vibratome Leica VT1000s</td>
			<td style="width:96px;">Leica</td>
			<td style="width:119px;">14047235613</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">UltraPure agarose</td>
			<td style="width:96px;">Invitrogen</td>
			<td style="width:119px;">16500500</td>
			<td style="width:167px;">Prepare 4% and 6% before use</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Injector blade</td>
			<td style="width:96px;">Ted Pella</td>
			<td style="width:119px;">121-4</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:216px;">MEM with Penicillin&#160; + Streptomycin</td>
			<td style="width:96px;">Media Core Facilities (MSKCC)</td>
			<td style="width:119px;"></td>
			<td style="width:167px;">The media is prepared at Memorial Sloan Kettering Cancer Center&#160;</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Scalpel no. 10</td>
			<td style="width:96px;">Thermo Scientific</td>
			<td style="width:119px;">31-200-32</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Disposable forceps</td>
			<td style="width:96px;">Cole-Parmer</td>
			<td style="width:119px;">84011182</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:216px;">Embedding mold</td>
			<td style="width:96px;">Electron Microscopy Science</td>
			<td style="width:119px;">70181</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">FBS (heat inactivated)</td>
			<td style="width:96px;">Gemini</td>
			<td style="width:119px;">100106</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">24 well plates</td>
			<td style="width:96px;">Corning</td>
			<td style="width:119px;">3524</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Formalin (10%)</td>
			<td style="width:96px;">Sigma Diagnostics</td>
			<td style="width:119px;">SDHT501128&#160;</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">16% Formaldehyde solution</td>
			<td style="width:96px;">Thermo Scientific</td>
			<td style="width:119px;">28908</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Embedding microsettes</td>
			<td style="width:96px;">Simport</td>
			<td style="width:119px;">M503-2</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Ethanol (70%)</td>
			<td style="width:96px;">Fisher Scientific</td>
			<td style="width:119px;">A405P-4</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Waterbath</td>
			<td style="width:96px;">Fisher Scientific</td>
			<td style="width:119px;">15-462-2SQ</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Microwave</td>
			<td style="width:96px;">General Electric</td>
			<td style="width:119px;">ModelJES2051DNBB</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Adhesive (Ethyl Cyanoacrylate)</td>
			<td style="width:96px;">Sigma-Aldrich</td>
			<td style="width:119px;">E1505-5G</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">10mm dishes</td>
			<td style="width:96px;">BD Falcon</td>
			<td style="width:119px;">353003</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:216px;">15ml tubes</td>
			<td style="width:96px;">BD Falcon</td>
			<td style="width:119px;">352096</td>
			<td style="width:167px;"></td>
		</tr>
	</tbody>
</table>

ex vivo treatment response of primary tumors and/or associated metastases for preclinical and clinical development of therapeutics

The molecular analysis of established cancer cell lines has been the mainstay of cancer research for the past several decades. Cell culture provides both direct and rapid analysis of therapeutic sensitivity and resistance. However, recent evidence suggests that therapeutic response is not exclusive to the inherent molecular composition of cancer cells but rather is greatly influenced by the tumor cell microenvironment, a feature that cannot be recapitulated by traditional culturing methods. Even implementation of tumor xenografts, though providing a wealth of information on drug delivery/efficacy, cannot capture the tumor cell/microenvironment crosstalk (i.e., soluble factors) that occurs within human tumors and greatly impacts tumor response. To this extent, we have developed an ex vivo (fresh tissue sectioning) technique which allows for the direct assessment of treatment response for preclinical and clinical therapeutics development. This technique maintains tissue integrity and cellular architecture within the tumor cell/microenvironment context throughout treatment response providing a more precise means to assess drug efficacy.

Per questo studio, la tecnica ex vivo è stato utilizzato in un&#39;analisi correlativa terapeutico sensibilità / resistenza di un inibitore della heat shock protein 90 (Hsp90i). In una valutazione preclinica di questo Hsp90i, il cancro al seno tumore primario, un ER + invasivo carcinoma duttale (IDC), e associata metastasi linfonodali sono stati analizzati ex-vivo per la risposta al trattamento &#160; (Figura 1). Più di 200 micron sezioni seriali sono stati trattati...

Watch this Scientific Journal Video about Ex Vivo Treatment Response of Primary Tumors and/or Associated Metastases for Preclinical and Clinical Development of Therapeutics at JoVE.com

Ex Vivo Treatment Response of Primary Tumors and/or Associated Metastases for Preclinical and Clinical Development of Therapeutics

Fondata linee cellulari tumorali e xenotrapianti sono stati il ​​cardine della ricerca sul cancro negli ultimi decenni. Tuttavia, recenti evidenze suggeriscono che la risposta terapeutica è fortemente influenzata dal microambiente delle cellule tumorali. Di conseguenza, abbiamo sviluppato una analisi ex vivo di campioni tumorali primarie per scopi di sviluppo della droga.

Ex Vivo risposta al trattamento di tumori primari e / o associati per metastasi preclinici e sviluppo clinico di Therapeutics

The molecular analysis of established cancer cell lines has been the mainstay of cancer research for the past several decades. Cell culture provides both ...

ex-vivo-treatment-response-primary-tumors-andor-associated-metastases

Research

JoVE Journal

Medicine

Ex Vivo Treatment Response of Primary Tumors and/or Associated Metastases for Preclinical and Clinical Development of Therapeutics

14.6K Views.  Memorial Sloan Kettering Cancer Center.  Fondata linee cellulari tumorali e xenotrapianti sono stati il ​​cardine della ricerca sul cancro negli ultimi decenni. Tuttavia, recenti evidenze suggeriscono che la risposta terapeutica è fortemente influenzata dal microambiente delle cellule tumorali. Di conseguenza, abbiamo sviluppato una analisi ex vivo di campioni tumorali primarie per scopi di sviluppo della droga. 

Video: Ex Vivo Treatment Response of Primary Tumors and/or Associated Metastases for Preclinical and Clinical Development of Therapeutics

Thermal Ablation for the Treatment of Abdominal Tumors

Percutaneous thermal ablation is an emerging treatment option for many tumors of the abdomen not amenable to conventional treatments. During a thermal ablation procedure, a thin applicator is guided into the target tumor under imaging guidance. Energy is then applied to the tissue until temperatures rise to cytotoxic levels (50-60 &deg;C). Various energy sources are available to heat biological tissues, including radiofrequency (RF) electrical current, microwaves, laser light and ultrasonic waves. Of these, RF and microwave ablation are most commonly used worldwide.
During RF ablation, alternating electrical current (~500 kHz) produces resistive heating around the interstitial electrode. Skin surface electrodes (ground pads) are used to complete the electrical circuit. RF ablation has been in use for nearly 20 years, with good results for local tumor control, extended survival and low complication rates1,2. Recent studies suggest RF ablation may be a first-line treatment option for small hepatocellular carcinoma and renal-cell carcinoma3-5. However, RF heating is hampered by local blood flow and high electrical impedance tissues (eg, lung, bone, desiccated or charred tissue)6,7. Microwaves may alleviate some of these problems by producing faster, volumetric heating8-10. To create larger or conformal ablations, multiple microwave antennas can be used simultaneously while RF electrodes require sequential operation, which limits their efficiency. Early experiences with microwave systems suggest efficacy and safety similar to, or better than RF devices11-13.
Alternatively, cryoablation freezes the target tissues to lethal levels (-20 to -40 &deg;C). Percutaneous cryoablation has been shown to be effective against RCC and many metastatic tumors, particularly colorectal cancer, in the liver14-16. Cryoablation may also be associated with less post-procedure pain and faster recovery for some indications17. Cryoablation is often contraindicated for primary liver cancer due to underlying coagulopathy and associated bleeding risks frequently seen in cirrhotic patients. In addition, sudden release of tumor cellular contents when the frozen tissue thaws can lead to a potentially serious condition known as cryoshock 16.
Thermal tumor ablation can be performed at open surgery, laparoscopy or using a percutaneous approach. When performed percutaneously, the ablation procedure relies on imaging for diagnosis, planning, applicator guidance, treatment monitoring and follow-up. Ultrasound is the most popular modality for guidance and treatment monitoring worldwide, but computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used as well. Contrast-enhanced CT or MRI are typically employed for diagnosis and follow-up imaging.

A thermal tumor ablation procedure is described. The entire procedure is detailed, including pretreatment planning and imaging studies, anesthesia, adjuvant techniques to facilitate a percutaneous approach, imaging guidance of the ablation device to the tumor, thermal treatment, post-treatment care and follow-up.

Ablazione termica nel trattamento dei tumori addominali

Percutaneous thermal ablation is an emerging treatment option for many tumors of the abdomen not amenable to conventional treatments. During a thermal ...

Ricerca

Medicina

Monitoring Tumor Metastases and Osteolytic Lesions with Bioluminescence and Micro CT Imaging

Following intracardiac delivery of MDA-MB-231-luc-D3H2LN cells to Nu/Nu mice, systemic metastases developed in the injected animals. Bioluminescence imaging using IVIS Spectrum was employed to monitor the distribution and development of the tumor cells following the delivery procedure including DLIT reconstruction to measure the tumor signal and its location.
Development of metastatic lesions to the bone tissues triggers osteolytic activity and lesions to tibia and femur were evaluated longitudinally using micro CT. Imaging was performed using a Quantum FX micro CT system with fast imaging and low X-ray dose. The low radiation dose allows multiple imaging sessions to be performed with a cumulative X-ray dosage far below LD50. A mouse imaging shuttle device was used to sequentially image the mice with both IVIS Spectrum and Quantum FX achieving accurate animal positioning in both the bioluminescence and CT images. The optical and CT data sets were co-registered in 3-dimentions using the Living Image 4.1 software. This multi-mode approach allows close monitoring of tumor growth and development simultaneously with osteolytic activity.

An experimental mouse model of bone metastasis was established following intracardiac delivery of luciferase expressing mammary tumor cells. Tumor development and resulted osteolytic lesion were monitored longitudinally with bioluminescence and micro CT imaging.

Monitoraggio metastasi tumorali e lesioni osteolitiche con bioluminescenza e Micro CT Imaging

Following intracardiac delivery of MDA-MB-231-luc-D3H2LN cells to Nu/Nu mice, systemic metastases developed in the injected animals. Bioluminescence ...

A Novel High-resolution In vivo Imaging Technique to Study the Dynamic Response of Intracranial Structures to Tumor Growth and Therapeutics

We have successfully integrated previously established Intracranial window (ICW) technology 1-4 with intravital 2-photon confocal microscopy to develop a novel platform that allows for direct long-term visualization of tissue structure changes intracranially. Imaging at a single cell resolution in a real-time fashion provides supplementary dynamic information beyond that provided by standard end-point histological analysis, which looks solely at 'snap-shot' cross sections of tissue.
Establishing this intravital imaging technique in fluorescent chimeric mice, we are able to image four fluorescent channels simultaneously. By incorporating fluorescently labeled cells, such as GFP+ bone marrow, it is possible to track the fate of these cells studying their long-term migration, integration and differentiation within tissue. Further integration of a secondary reporter cell, such as an mCherry glioma tumor line, allows for characterization of cell:cell interactions. Structural changes in the tissue microenvironment can be highlighted through the addition of intra-vital dyes and antibodies, for example CD31 tagged antibodies and Dextran molecules.
Moreover, we describe the combination of our ICW imaging model with a small animal micro-irradiator that provides stereotactic irradiation, creating a platform through which the dynamic tissue changes that occur following the administration of ionizing irradiation can be assessed.
Current limitations of our model include penetrance of the microscope, which is limited to a depth of up to 900 &mu;m from the sub cortical surface, limiting imaging to the dorsal axis of the brain. The presence of the skull bone makes the ICW a more challenging technical procedure, compared to the more established and utilized chamber models currently used to study mammary tissue and fat pads 5-7. In addition, the ICW provides many challenges when optimizing the imaging.

A Novel High-resolution In vivo Imaging Technique to Study the Dynamic Response of Intracranial Structures to Tumor Growth and Therapeutics

We describe a novel in vivo imaging technique that couples fluorescent chimeric mice with intracranial windows and high-resolution 2-photon microscopy. This imaging platform aids studies of dynamic changes in brain tissue and microvasculature, at a single-cell level, following pathological insults and is adaptable to assess intracranial drug delivery and distribution.

Un romanzo ad alta risoluzione<em&gt; In vivo</em&gt; Tecnica di imaging per studiare la risposta dinamica di strutture intracraniche alla crescita del tumore e Terapeutica

We have successfully integrated previously established Intracranial window (ICW) technology 1-4 with intravital 2-photon confocal microscopy to develop a ...

Adaptation of Semiautomated Circulating Tumor Cell (CTC) Assays for Clinical and Preclinical Research Applications

The majority of cancer-related deaths occur subsequent to the development of metastatic disease. This highly lethal disease stage is associated with the presence of circulating tumor cells (CTCs). These rare cells have been demonstrated to be of clinical significance in metastatic breast, prostate, and colorectal cancers. The current gold standard in clinical CTC detection and enumeration is the FDA-cleared CellSearch system (CSS). This manuscript outlines the standard protocol utilized by this platform as well as two&#160;additional adapted protocols that describe the detailed process of user-defined marker optimization for protein characterization of patient CTCs and a comparable protocol for CTC capture in very low volumes of blood, using standard CSS reagents, for studying in vivo preclinical mouse models of metastasis. In addition, differences in CTC quality between healthy donor blood spiked with cells from tissue culture versus patient blood samples are highlighted. Finally, several commonly discrepant items that can lead to CTC misclassification errors are outlined. Taken together, these protocols will provide a useful resource for users of this platform interested in preclinical and clinical research pertaining to metastasis and CTCs.

Adaptation of Semiautomated Circulating Tumor Cell CTC Assays for Clinical and Preclinical Research Applications

Circulating tumor cells (CTCs) are prognostic in several metastatic cancers. This manuscript describes the gold standard CellSearch system (CSS) CTC enumeration platform and highlights common misclassification errors. In addition, two&#160;adapted protocols are described for user-defined marker characterization of CTCs and CTC enumeration in preclinical mouse models of metastasis using this technology.

Adattamento del semiautomatico circolanti (CTC) Saggi Tumor Cell per applicazioni cliniche e di ricerca preclinica

The majority of cancer-related deaths occur subsequent to the development of metastatic disease. This highly lethal disease stage is associated with the ...

A Preclinical Murine Model of Hepatic Metastases

Numerous murine models have been developed to study human cancers and advance the understanding of cancer treatment and development. Here, a preclinical, murine pancreatic tumor model of hepatic metastases via a hemispleen injection of syngeneic murine pancreatic tumor cells is described. This model mimics many of the clinical conditions in patients with metastatic disease to the liver. Mice consistently develop metastases in the liver allowing for investigation of the metastatic process, experimental therapy testing, and tumor immunology research.

A preclinical, murine model of hepatic metastases performed via a hemispleen injection technique.

Un preclinici Modello murino di metastasi epatiche

Numerous murine models have been developed to study human cancers and advance the understanding of cancer treatment and development. Here, a preclinical, ...

Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma

Isolated hepatic perfusion (IHP) is a procedure where the liver is surgically isolated and perfused with a high concentration of the chemotherapeutic agent melphalan. Briefly, the procedure starts with the setup of a percutaneous veno-venous bypass from the femoral vein to the external jugular vein. Via a laparotomy, catheters are then inserted into the proper hepatic artery and the caval vein. The portal vein and the caval vein, both supra- and infrahepatically, are then clamped. The arterial and venous catheters are connected to a heart lung machine and the liver is perfused with melphalan (1 mg/kg body weight) for 60 min. This way it is possible to locally perfuse the liver with a high dose of a chemotherapeutic agent, without leakage to the systemic circulation.
In previous studies including patients with isolated liver metastases of uveal melanoma, an overall response rate of 33-100% and a median survival between 9 and 13 months, have been reported. The aim of this protocol is to give a clear description of how to perform the procedure and to discuss IHP as a treatment option for liver metastases of uveal melanoma.

Here, we present a protocol how to perform an isolated liver perfusion (IHP) with melphalan and we also discuss IHP as a treatment option for liver metastases of uveal melanoma.

Isolata epatica perfusione come Trattamento di metastasi epatiche di melanoma uveale

Isolated hepatic perfusion (IHP) is a procedure where the liver is surgically isolated and perfused with a high concentration of the chemotherapeutic ...

Generation of Microtumors Using 3D Human Biogel Culture System and Patient-derived Glioblastoma Cells for Kinomic Profiling and Drug Response Testing

The use of patient-derived xenografts for modeling cancers has provided important insight into cancer biology and drug responsiveness. However, they are time consuming, expensive, and labor intensive. To overcome these obstacles, many research groups have turned to spheroid cultures of cancer cells. While useful, tumor spheroids or aggregates do not replicate cell-matrix interactions as found in vivo. As such, three-dimensional (3D) culture approaches utilizing an extracellular matrix scaffold provide a more realistic model system for investigation. Starting from subcutaneous or intracranial xenografts, tumor tissue is dissociated into a single cell suspension akin to cancer stem cell neurospheres. These cells are then embedded into a human-derived extracellular matrix, 3D human biogel, to generate a large number of microtumors. Interestingly, microtumors can be cultured for about a month with high viability and can be used for drug response testing using standard cytotoxicity assays such as 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and live cell imaging using Calcein-AM. Moreover, they can be analyzed via immunohistochemistry or harvested for molecular profiling, such as array-based high-throughput kinomic profiling, which is detailed here as well. 3D microtumors, thus, represent a versatile high-throughput model system that can more closely replicate in vivo tumor biology than traditional approaches.

Patient-derived xenografts of glioblastoma multiforme can be miniaturized into living microtumors using 3D human biogel culture system. This in vivo-like 3D tumor assay is suitable for drug response testing and molecular profiling, including kinomic analysis.

Generazione di Microtumors Uso 3D Biogel Umano Sistema Cultura e cellule di glioblastoma paziente-derivato per Kinomic Profiling and Drug Testing risposta

The use of patient-derived xenografts for modeling cancers has provided important insight into cancer biology and drug responsiveness. However, they are ...

Assessment of Spontaneous Alternation, Novel Object Recognition and Limb Clasping in Transgenic Mouse Models of Amyloid-&#946; and Tau Neuropathology

Here we describe a staged, behavioral testing approach that can be used to screen for compounds that exhibit in vivo efficacy on cognitive and functional motor behaviors in transgenic mouse models of &#946;-amyloidosis and tauopathy. The paradigm includes tests for spontaneous alternation in a Y-maze, novel object recognition, and limb clasping. These tests were selected because they: 1) interrogate function of cognitive or motor domains and the correlate neural circuitry relevant to the human disease state, 2) have clearly defined endpoints, 3) have easily implementable quality control checks, 4) can be run in a moderate throughput format, and 5) require little intervention by the investigator. These methods are designed for investigators looking to screen compounds for activity in short-term and working memory tasks, or functional motor behaviors associated with Alzheimer's disease mouse models. The methods described here use behavioral tests that engage a number of different brain regions including hippocampus and various cortical areas. Investigators that desire cognitive tests that specifically assess cognition mediated by a single brain region could use these techniques to supplement other behavioral tests.

Assessment of Spontaneous Alternation, Novel Object Recognition and Limb Clasping in Transgenic Mouse Models of Amyloid-&amp;#946; and Tau Neuropathology

Described here is a staged, behavioral screening approach that can be used to screen for compounds that exhibit in vivo efficacy on cognitive and functional motor behaviors in transgenic mouse models of &#946;-amyloidosis and tauopathy. These methods are optimized to screen compounds for activity in short-term and working memory tasks.

Valutazione di alternanza spontanea, riconoscimento novello di oggetti e attacco degli arti nei modelli di topo transgenico Modelli di neuropathologia di Amiloide-β e Tau

Here we describe a staged, behavioral testing approach that can be used to screen for compounds that exhibit in vivo efficacy on cognitive and functional ...

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

The prognosis of patients with metastatic cancers has improved in the past decades due to effective chemotherapy and oligometastatic surgery. For inoperable patients, local ablation therapies, such as stereotactic body radiotherapy (SBRT), can provide effective local tumor control with minimal toxicity. Because of its high precision and accuracy, SBRT delivers a higher radiation dose per fraction, is more effective, and targets smaller irradiation volumes than does conventional radiotherapy. In addition, steep dose gradients from target lesions to surrounding normal tissues are achieved using SBRT; thus, SBRT provides more effective tumor control and exhibits fewer side effects than conventional radiotherapy. The use of SBRT is prevalent for treating intracranial lesions (known as stereotactic radiosurgery); however, it is now also used for treating spinal and adrenal metastases. Because of advancements in image-guided assistance and respiratory motion management, several studies have investigated the use of SBRT for treating lung or liver tumors, which move as a patient breathes. The results of these studies have suggested that SBRT favorably controls tumors in the case of moving lesions.
Four-dimensional computed tomography (4D-CT) with an abdominal compressor (AC) is clinically convenient for effective respiratory motion management. Because this method is noninvasive and allows free breathing, its use reduces complications. Furthermore, patients consider this method convenient. Moreover, it is considered more efficient than other methods of respiratory motion management by physicians and therapists. The use of 4D-CT with an AC for treating pulmonary lesions has also been widely investigated, and the technique is gaining acceptance for treating hepatic lesions. However, the protocols for using 4D-CT with an AC for treating hepatic lesions are different from those used for treating pulmonary lesions. In this article, we describe a new protocol for SBRT with 4D-CT and an AC for treating liver metastases.

Stereotactic body radiotherapy (SBRT) requires rigorous accuracy and precision for delivering high radiation doses per fraction to small treatment volumes to improve tumor control and simultaneously reduce toxicity. Herein, we present a noninvasive and clinically convenient respiratory motion management protocol for SBRT for liver metastases.

Trattamento delle metastasi del fegato usando un metodo di Volume bersaglio interno per la radioterapia stereotassica corpo

The prognosis of patients with metastatic cancers has improved in the past decades due to effective chemotherapy and oligometastatic surgery. For ...

Contractions of Human-iPSC-derived Cardiomyocyte Syncytia Measured with a Ca-sensitive Fluorescent Dye in Temperature-controlled 384-well Plates

Spontaneously contracting syncytia of cardiomyocytes derived from human-induced pluripotent stem cells (hiPSC-CM) are a useful model of human cardiac physiology and pharmacology. Various methods have been proposed to record this spontaneous activity and to evaluate drug effects, but many of these methods suffer from limited throughput and/or physiological relevance. We developed a high-throughput screening system to quantify the effects of exogenous compounds on hiPSC-CM's beating frequency, using a Ca-sensitive fluorescent dye and a temperature-controlled imaging multi-well plate reader. We describe how to prepare the cell plates and the compound plates and how to run the automated assay to achieve high sensitivity and reproducibility. We also describe how to transform and analyze the fluorescence data to provide reliable measures of drug effects on spontaneous rhythm. This assay can be used in drug discovery programs to guide chemical optimization away from, or toward, compounds affecting human cardiac function.

Spontaneously contracting syncytia of cardiomyocytes derived from human-induced pluripotent stem cells are useful models of human cardiac physiology and pharmacology. Here we present a high-throughput screening system to quantify the effects of exogenous compounds on beating frequency, using a Ca-sensitive fluorescent dye and a temperature-controlled imaging multi-well plate reader.

Contrazioni di umano-iPSC-derivato del Cardiomyocyte sincizi misurata con un colorante fluorescente Ca sensibile a temperatura controllata piastre da 384 pozzetti

Spontaneously contracting syncytia of cardiomyocytes derived from human-induced pluripotent stem cells (hiPSC-CM) are a useful model of human cardiac ...