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.

참고 : 환자 조직 조달이 제도적 검토위원회 (IRB)를 통해 권한이 부여 된 기념 슬로안 케터링 암 센터에서 Biospecimen 및 임상 프로토콜 (프로토콜 번호는 각각 09-121 및 11-041을) -approved. 1 조직 조달 <ol><li> 환자의 기본 종양 / 전이 조달 참고 : 현재까지,이 프로토콜은 수술로 제거 췌장, 위 및 유방 종양 유형뿐만 아니라, 같은 림프종 전이에 수행되었습니다. <ol><li> 멸균 유출 방지 컨테이너 내의 밀봉 및 살균 누수 방지 플라스틱 시편 가방에 병리학 부서에 택배 또는 공압 튜브 시스템에 의해 표본을 제공하기 위해 외과 팀을 직접. 더 포르말린 고정액으로 신선한 상태의 시료를 수송 할 수있는 외과 팀을 직접. </li><li> 어느 것이 Inc의 멸균 기술을 사용하여 신선한 표본을 채취하기 위해 병리학 자 또는 병리학 지원을 직접층류 후드 멸균 장갑과 악기의 ludes 사용. </li><li> 수술의 완성에서 30 분에서 엄격하게 유지된다 조달 시료의 채취 시간을 기록한다. 냉 허혈을 고려하여 효과를 고려,&gt; 30 분 (18)의 감기 허혈성 시간 절제술에서 샘플을 채취하지 않습니다. </li><li> 무균 환경을 유지하기 위해 층류 후드에서 1.0 cm (3)에 약 0.5 cm (3)의 일차 종양 표본을 제거하는 병리학 부서 담당자 직접. 가능하면, 전위 프랭크 중앙 괴사 (세포 사멸)를 피하기 위해 인덱스 병변의 주변부로부터 종양 조직을 선택한다. 참고 : 괴사 조직은 다음 기준 중 하나에 의해 심하게 인식 할 수 있습니다 : 색상이나 조직의 창백 손실; 괴사 조직 부드럽고 무른 인 강도의 손실; 괴사 및 실행 가능한 조직 사이에 뚜렷한 경계. </li><li> pathologi 직접성 또는 병리학 보조 진단 평가를위한 종양의 즉각적인 샘플링 초과 후 (수술 폐기)에 주변 조직을 제공합니다. 약 5 ㎖의 1 % 항생제 (페니실린과 스트렙토 마이신)를 포함하는 최소 필수 미디어 (MEM)의 포함 된 15 ㎖의 멸균 원뿔 원심 분리 관에 시료를 놓습니다. </li><li> 사용 가능한 (예를 들어, 유방 절제 표본의 겨드랑이 꼬리 림프절)은 같은 크기 (0.5 cm 3 cm 3 내지 1.0)의 조잡한 포지티브 관련된 림프절 표본을 조달 일차 종양의 약물 반응과 비교하면. 일차 종양 표본 마찬가지로, 1 % 항생제 (페니실린 스트렙토 마이신)를 포함하는 약 5 ㎖의 최소 필수 매체 (MEM)의 함유를 15 ㎖의 멸균 원추형 원심 분리 튜브에 연결된 림프절 표본을 배치. </li><li> 만약 즉 수술 표본 허가 (예를 들어, 유방 절제 표본)을, (주 종양에서 먼) 제거의 정상 조직 샘플 (크기,약 5 ml의 전송만을 목적으로 1 %의 항생제를 함유하는 최소 필수 매체 (MEM)의 함유를 15 ㎖의 멸균 원추형 원심 분리 관에서 통상 고밀도 / 섬유질 유방 실질)​​ 및 장소. 실험실 시설 이전에 따라,에 cryovial, &#39;스냅&#39;동결 및 저장에 &#39;정상&#39;표본을 전송 -80 C의 냉동고 ° 향후 분자 분석을 위해. </li><li> 젖은 얼음에 모든 시편을 놓고 즉시 생체 신선한 조직 절편에 대한 실험실 공간으로 운반 할 것. 하지 부에게 정상적인 시료를 수행 아니라 미래의 분자 분석을위한 C의 냉동고 °에 -80 저장합니다. 미래의 분자 분석을 위해 -80 ° C의 냉동고에 cryovial, &#39;스냅&#39;동결 및 저장에 대한 기본 종양의 부분과 관련된 전이을 전송합니다. </li></ol></li><li> 임상 연구에서 조직의 조달 (예, 선택적 코어 생검 바늘 (CNB)) 참고 : 우리는 환자의 종양 조직을 얻을치료 시작 전 액세스 종양 전이 CNB을 거쳐 그들의 동의를 임상 프로토콜에 등록. CNBs는 현재까지 유방암, 한계 영역 림프종, 맨틀 세포 림프종, 전이성 paraganglioma, 자궁 경부 (편평 상피 세포) 및 난소 암 환자에서 수행되었다. <ol><li> 중재 방사선 또는 관련 부서로부터 임상 인력 함유 멸균 원추형 원심 분리 관을 전처리 코어 생검을 수행하고 15 ml의 시료를 배치 유무 약 5 ㎖의 1 % 항생제 (페니실린 스트렙토 마이신)을 함유하는 최소 필수 매체 (MEM)의. </li><li> 젖은 얼음에 생검 표본을 놓고 즉시 생체 신선한 조직 절편에 대한 실험실 공간으로 운반 할 것. </li></ol></li></ol> 단면 및 Vibratome 설정 재료의 2 준비 <ol><li> 단면 용 재료의 제조 <ol><li> AGA 4 g을 첨가하여 4 % 아가로 오스 용액을 만들기PBS 100 ㎖로 상승했다. 오토 클레이브 (주기 설정 : 액체, 121 ° C, 30 분, 평방 인치 당 15파운드)를 처음 사용할 경우, 사용하기 전에 솔루션을 제공합니다. 이후 용도를 위해, 아가로 오스는 RT에서 굳은 것을 염두에 각각 사용하기 전에 (30 초 간격으로 높은 열을) 액화 적절 ~ 25 ° C (즉, 따뜻한 터치)으로 냉각 전자 레인지에서 4 % 아가로 오스를 배치합니다. </li><li> 비 영구적 인 조직 내장 매체로 4 % 아가로 오스를 사용합니다. 4 %의 아가 로스를 충분히 냉각하고 무균 집게 매립 금형 티슈 시편을 넣고 4 % 아가 로즈 부어와 액체 상태 여전히 때. </li><li> 매립 금형의 절삭면의 벽에 직접 주변 조직 시료 (~ 2mm의 거리)를 배치 아니지만. 4 % 아가로 신속 고화하기 때문에 적절히 빠르게 조직 시편을 위치시킨다. 단면 동안 솔루션을 유지하기위한 55 ° C의 물을 욕조에 4 % 아가로 오스를 유지합니다. </li><li> 단면 분석 24 웰 플레이트에 1 ㎖의 O 추가각 웰에 F 완전한 미디어 (즉, MEM + 10 % 소 태아 혈청 + 1 % 항생제). 단면의 기간에 걸쳐 RT (~ 25 ° C)에서 24 웰 플레이트를 유지합니다. </li></ol></li><li> Vibratome 설정의 준비 <ol><li> 진동 마이크로톰을 사용하여, (10)에 칼날이 시험편에 접근하는 속도 [10 (2.5 mm / 초) 0 (0.00 mm / 초)]와 블레이드 [0 (0 Hz에서)의 주파수를 설정 (100 Hz에서) ]. 조직 (즉, 밀도 / 탄력)의 질감에 따라 설정을 조정합니다. </li><li> 침윤성 암의 주요 유방 종양의 경우, 각각 6, 3, 속도 및 주파수 설정을 조정합니다. 밀도가 낮은 / 회사 종양 조직의 경우, 속도가 감소하고 그에 따라 주파수를 증가시킨다. </li><li> (- 999 μm의 1) 기기의 범위 내에서 부분의 두께를 설정합니다. 이러한 분석의 경우, 200 μm의에서 단면 두께를 설정합니다. </li><li> 시험편 디스크 그쪽에 액상 접착제의 얇은 층을 사용하여 아가로 포매 표본 마운트t는 젖은 얼음에 쌌다 미디어의 저수지에 잠겨있다. </li></ol></li></ol> 3 조직 단면, 처리 및 분석 <ol><li> 즉시 전체 미디어의 1 ml의 멀티 웰 플레이트에서 멸균 포셉과 장소를 사용하여 단면에 정밀 슬라이스 섹션을 제거합니다. 충분한 부분이 상호 반응 및 분석을 위해 획득 될 때, 표준 조직 배양 조건 설정 조직 배양 인큐베이터에서 치료 반응을 위해 멀티 웰 플레이트를 배치했다. </li><li> 배양 아티팩트 반대로 용량 의존적 반응을 확인하기위한 노력으로 처리 된 부분 책꽂이 다중 제어부를 타고. (- 4 시간 ~ 2) 18도 차가운 허혈 시간의 해로운 영향에서, - (40 분 ~ 30) 조직 빠르게 단면을 수행합니다. 단지 1 시간의 순응 기간 다음 섹션의 치료를 수행합니다. </li><li> 1 시간의 순응 기간에 따라, 용량 (치료 관련 증가 추가; <em.&gt; 예, 0 - 치료 기간에 대한 표준 조직 배양 조건에서 섹션과 집으로 약물의 10 μM 농도). 이 연구를 위해 24 및 / 또는 48 시간 평가 기간을 사용합니다. 및 96 시간 평가 기간까지의 기간 동안, 본 연구에서 시험 그러나 제어 (차량 전용) 조직 섹션은 가능한 유지됩니다. </li><li> 치료 후, RT O에서 10 % 포르말린과 장소를 포함하는 튜브에 조직 절편을 배치하여 멸균 조건 및 포르말린으로 고정 섹션이 모두 제거 / N 또는 4 % 파라 포름 알데히드를 함유하는 튜브 (유리 병에서 16 % 파라 포름 알데히드를 희석 2 시간 동안 RT에서 4 %의 최종 농도) 및 장소와 PBS. <ol><li> 큰 조직 섹션을 수정 (예. ~ 6mm X 4mm) 10 % 포르말린의 O에서 200 μm의 두께 / RT에서 N. 작은 부분을 수정 (예를 들면., 1mm X 1mm) 실온에서 2 시간 동안 4 % 파라 포름 알데히드에서 200 μm의 두께. NOTE : 정착액 (F)의 양을 효율적으로 침투ixative 조직의 부피를 20 배한다. 주어진 적절한 고정 사용하는 모든 조직의 크기에 정착 1 ㎖의 보증을위한 매우 작은 조직의 크기 (예를 들어, 6mm 3 조직 = 6 μL 볼륨),이 프로토콜의 결과. </li><li> 고정 후 조직 표본은 병리학 부서 담당자가 포함 된 파라핀있다. 충전 슬라이드 위에 파라핀 블록 표본 섹션 헤 마톡 실린 및 스테인드 에오신 및 평가 면역 조직 화학적 (예를 들면, 세포 사멸) 할 수 있습니다. </li></ol></li></ol>

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M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ex+vivo+culture+of+human+prostate+tissue+and+drug+development.">Ex vivo culture of human prostate tissue and drug development.</a> Nature Reviews Urology. 10, 483-487 (2013).</li><li>Jhaveri, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Heat+shock+protein+90+inhibitors+in+the+treatment+of+cancer:+current+status+and+future+directions.">Heat shock protein 90 inhibitors in the treatment of cancer: current status and future directions.</a> Expert Opinion on Investigational Drugs. 5, 611-628 (2014).</li><li>Gerecitano, J. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Using+124-PU-H71PET+imaging+to+predict+intratumoral+concentration+in+patients+on+a+phase+I+trial+of+PU-H71.">Using 124-PU-H71PET imaging to predict intratumoral concentration in patients on a phase I trial of PU-H71.</a> Journal of Clinical Oncology. 31, 11076-11 (2013).</li><li>Yildiz-Aktas, I., Dabbs, D. J., Bhargava, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+cold+ischemic+time+on+the+immunohistochemical+evaluation+of+estrogen+receptor,+progesterone+receptor,+and+HER2+expression+in+invasive+breast+carcinoma.">The effect of cold ischemic time on the immunohistochemical evaluation of estrogen receptor, progesterone receptor, and HER2 expression in invasive breast carcinoma.</a> Modern Pathology. 25, 1098-1105 (2012).</li></ol>

No conflicts of interest disclosed.

효과적인 치료 전략을 개발하려고 할 때 암 생물 학자들은 상당한 도전에 직면하고 있습니다. 확립 암 세포주에서 약물 개발을 테스트하는 것은 정확하게 생체 반응과 PDX 모델에서 생체 내 실험은 노동 집약적이고 비용이 매우 다를 수있다. 상기를 감안 기본 환자의 생체 기술의 애플리케이션 (15)은 현재 설정된 암 세포주와 환자 유래의 이종 이식 (PDX)의 분자량 분석 ...

효과적인 암 치료제를 개발하는 것이 매우 어려운 것으로 입증되었습니다. 암 세포주와 종양 이식편 -뿐만 아니라 이종 절반 위에 세기 1,2,3 대한 암 연구에서 사용되어왔다. 현재까지, 약물 감수성 및 내성 둘 확립 암 세포주 및 이종 이식 환자 유래의 분자량 분석 (PDX)이 필수적이다. 그러나, 확립 암 세포주에서의 시험 화합물들은 생체 내 효능을 예측할 수없고, 특히 PDX 모델에서, 동물의 생체 내 연구에 대응하는, 매우 많은 비용과 시간이 소요된다. 이 모델 시스템, 종양 진행 및 치료 전략에 응답하여 네이티브 미세의 영향에 알리는 즉 무능력의 한계는 이러한 분석을 보완하기위한 추가 방법을 개발하는 연구 분야를 주도하고있다. 최근의, 높아진 관심은 환자 다치의 생체 분석으로 지급되는암 치료 반응은 암세포의 내재적 분자 조성물 단독이 아니라 오히려 크게 기존 배양 방법에 의해 효과적으로 요약 할 수없는 종양 세포 미세 환경 (6, 7) 기능에 의해 영향을 받는다는 인해 큰 이해 또는 이식편 4, 5 / 또는 PDX. 상기 컨텍스트의 생체 외 분석 (예. 인접한 주위 종양 세포 미세 환경의 영향)보다는 셀룰러 균주 8, 9의 생체 외 분석을보다 실용적 일차 종양 / 전이 섹션의 평가를 의미한다. 우리는 모두 환자의 기본 종양 (정밀 분리 된 신선한 조직 섹션 즉.) 및 관련 전이 (즉, 림프절)을 충실하게 응답에 알립니다 (IC50), 오프 대상 효과 생체 기술에 여기에보고하고 분자 수 있습니다 저항과 피드백 메커니즘의 분석. 치료 적 레이저 각막 절제의 또한, 상관 관계 분석바이오 마커 및 유전자 발현 프로파일 대 utic 감도 / 저항 (즉. 높은 약물 반응이 특히 생물학적 프로필을 가진 환자와 일치) 관심 실험 약물에 반응 할 가능성 환자를 확인하기 위해 수행 될 수있다. 다중 매개 변수 방식으로 생체 기술과 평가의 적용은 환자의 선택과 임상 결과의 전반적인 개선을 향한 움직임이다. 생체 내 치료 반응 분석은 암 치료제의 전임상 및 임상 개발의 표준 도구가 될 수 있고, 치료 개발 전략에 맞춤 의학의 접근 방식으로 단계로 구상된다.

<table border="0" cellpadding="0" cellspacing="0" width="598">
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			<td height="43" style="height:43px;width:216px;">Name of Material/ Equipment</td>
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			<td style="width:167px;">Comments/Description</td>
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			<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>
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		<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>
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		<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>
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		<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>
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		<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>
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		<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>
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		<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>
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		<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>
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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.

이 연구를 위해 생체 외 기술은 열 충격 단백질 90 저해제 (Hsp90i)의 치료 감수성 / 내성 상관 분석에 사용 하였다. 이 Hsp90i, 유방암 일차 종양, ER + 침윤성 암종 (IDC), 및 관련된 림프절 전이의 임상 평가에 치료 반응을위한 생체 외 분석 하였다 &#160; (그림 1). 여러 200 μm의 시리얼 섹션 Hsp90i의 차량 만 증가 복용량 (0.25, 0.50, 1.0 및 2.5 μM)로 처리 하였다. 그?...

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

설립 암 세포주 및 이종 이식편은 지난 수십 년간 암 연구의 주류이었다. 그러나, 최근의 증거는 치료 반응이 크게 종양 세포 미세 환경에 의해 영향을 받는다는 의미한다. 따라서, 우리는 약물 개발을 목적으로 일차 종양 시료의 생체 외 분석을 개발 하였다.

기본 종양 및 / 또는 전임상에 대한 관련 전이 및 치료제의 임상 개발의 전 생체 치료 응답

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 조회수.  Memorial Sloan Kettering Cancer Center.  설립 암 세포주 및 이종 이식편은 지난 수십 년간 암 연구의 주류이었다. 그러나, 최근의 증거는 치료 반응이 크게 종양 세포 미세 환경에 의해 영향을 받는다는 의미한다. 따라서, 우리는 약물 개발을 목적으로 일차 종양 시료의 생체 외 분석을 개발 하였다. 

비디오: 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.

복부 종양의 치료를위한 열 절제

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

연구

의학

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.

Bioluminescence 및 마이크로 중부 표준시 이미징과 함께 종양의 Metastases 및 Osteolytic 조직 손상을 모니터링

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.

소설 고해상도<em&gt; 생체 내</em종양의 성장과 치료학에 두개 내 구조물의 동적 응답을 공부하기&gt; 이미징 기술

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.

임상 및 전임상 연구 응용 프로그램에 대한 종양 세포 (CTC) 분석 실험을 순환 반자동의 적응

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.

간 전이의 전임상 쥐과 모델

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.

포도막 흑색 종의 간전이에 대한 치료로 고립 간 관류

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.

Kinomic 프로파일 의약품 응답 테스트를위한 3D 인간의를 Biogel 문화 시스템을 사용 Microtumors 및 환자 유래 아교 모세포종 세포의 생성

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.

아밀로이드 -β 및 타우 신경 병증의 유전자 변형 마우스 모델에서 자발적 교대, 새로운 대상 인식 및 사지 걸림의 평가

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.

몸 정위 적 방사선 치료에 대 한 내부 대상 볼륨 메서드를 사용 하 여 간 전이의 치료

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.

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