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: colheita de tecidos do paciente, autorizado por conselho de revisão institucional (IRB) -aprovado Biospecimen e Protocolos Clínicos (números de protocolo 09-121 e 11-041, respectivamente) no Memorial Sloan Kettering Cancer Center. Procurement 1 Tissue <ol><li> Aquisição de paciente primário tumor / metástase NOTA: Até à data, este protocolo foi realizado em pancreáticos, gástricos e tipos de tumor da mama removidos cirurgicamente, bem como, as metástases de linfoma. <ol><li> Direcionar a equipe cirúrgica para entregar a amostra por correio ou sistema de tubos pneumáticos para o departamento de Patologia em hermeticamente fechado e estéril saco plástico espécime à prova de vazamentos dentro de recipiente à prova de derrame estéril. Direcionar a equipe cirúrgica para transportar a amostra no estado fresco, sem formol ou fixador. </li><li> Dirigir o patologista ou patologista assistente para colher a amostra frescos utilizando uma técnica estéril, que inclui uso de luvas e instrumentos esterilizados sob uma capela de fluxo laminar. </li><li> Anote o tempo de colheita das amostras adquiridas, que é mantido rigorosamente menos de 30 min a partir da conclusão do procedimento cirúrgico. Levando-se em conta os efeitos de isquemia fria, não tome amostras de espécimes ressecados, com um tempo de isquemia fria de&gt; 30 min 18. </li><li> Dirigir o pessoal do Departamento de Patologia para remover uma amostra do tumor primário de aproximadamente 0,5 cm3 a 1,0 cm 3 de uma câmara de fluxo laminar, para manter um ambiente estéril. Quando possível, escolher o tecido do tumor a partir da periferia da lesão, para evitar potenciais índice de necrose central (morte celular) franca. NOTA: O tecido necrótico pode ser grosseiramente reconhecível por qualquer um dos seguintes critérios: a perda de cor ou palidez do tecido; perda de força em que o tecido necrosado é macio e friável; uma demarcação clara entre o tecido necrosado e viável. </li><li> Dirigir o pathologiST ou assistente patologista para fornecer tecido periférico que é em excesso (descarte cirúrgico), após a recolha imediata do tumor para avaliação diagnóstica. Colocar a amostra num tubo de centrífuga cónico de 15 ml estéril contendo cerca de 5 ml de meio essencial mínimo (MEM) contendo 1% de antibióticos (penicilina e estreptomicina). </li><li> Se estiver disponível (por exemplo, linfonodo axilar de cauda de espécime mastectomia), adquirir um grosseiramente positivos espécime gânglio linfático do mesmo tamanho (0,5 cm 3 a 1,0 cm 3) e comparar a resposta à droga do tumor primário. Como as amostras de tumor primário, colocar as amostras de nódulos linfáticos associados em um tubo de centrífuga cónico de 15 ml estéril contendo cerca de 5 ml de meio essencial mínimo (MEM) contendo 1% de antibióticos (penicilina e estreptomicina). </li><li> Se o tamanho de licenças peça cirúrgica (por exemplo, espécime mastectomia), remova (distante do tumor primário) de uma amostra de tecido normal (ou seja,fibrosa parênquima normal densa / peito) e colocar em um tubo de centrífuga cônico de 15 ml estéril contendo aproximadamente 5 ml de meio essencial mínimo (MEM) contendo 1% de antibióticos apenas para fins de transferência. Após a transferência para as instalações de laboratório, transferir a amostra &#39;normal&#39; para um, congelar e armazenar cryovial &#39;estalo&#39; em um freezer -80 ° C para análises moleculares futuras. </li><li> Coloque todas as amostras em gelo molhado e transportar imediatamente para o espaço de laboratório para ex vivo de corte de tecido fresco. Não secção do espécime normal, mas sim armazenar em um freezer -80 ° C para análises moleculares futuras. Transfira uma porção do tumor primário e de metástases associadas a um, congelar e armazenar criotubo &quot;pressão&quot; de uma temperatura de -80 ° C congelador para futuras análises moleculares. </li></ol></li><li> Aquisição de tecido a partir de estudos clínicos (por exemplo, biópsias com agulha grossa opcional (CNB)) ATENÇÃO: Nós obter tecidos tumorais de pacientesmatriculados em protocolos clínicos que dão o seu consentimento se submeter a uma CNB de uma metástase de tumor acessíveis antes do início da terapia. CNBS, até à data, têm sido realizados em pacientes com câncer de mama, linfoma da zona marginal, linfoma de células do manto, paraganglioma metastático, colo do útero (de células escamosas) e ovário. <ol><li> Ter pessoal clínico de Radiologia Intervencionista ou departamento competente realizar uma biópsia com agulha pré-tratamento e colocar a amostra em um tubo de centrífuga de 15 ml cônico estéril contendo aproximadamente 5 ml de meio essencial mínimo (MEM) contendo 1% de antibióticos (penicilina e estreptomicina). </li><li> Coloque a amostra de biópsia no gelo molhado e transportar imediatamente para o espaço de laboratório para ex vivo de corte de tecido fresco. </li></ol></li></ol> 2 Preparação de materiais para corte e Vibratome Configurações <ol><li> Elaboração de Materiais para Seccionamento <ol><li> Adicione uma solução de agarose a 4% por adição de 4 g de agasubiu para 100 ml de PBS. Autoclave (configurações de ciclo: Líquido, 121 ° C, 30 min, 15 libras por polegada quadrada), a solução antes do primeiro uso. Para utilizações seguintes, coloque a agarose 4% em um micro-ondas para liquefazer (fogo alto por intervalos de 30 segundos) antes de cada utilização e resfriar adequadamente para ~ 25 ° C (ou seja, quente ao toque) consciente de que agarose solidifica à temperatura ambiente. </li><li> Use a agarose 4% como uma mídia tecido incorporação não permanente. Quando a agarose 4% esfriou o suficiente e ainda está em estado líquido, com uma pinça estéril, colocar as amostras de tecido em um molde de incorporação e despeje a agarose 4%. </li><li> Posicione a amostra de tecido estreitas (~ mm distância 2), mas não diretamente na parede superfície de corte do molde de incorporação. A agarose a 4% começa a solidificar rapidamente, por conseguinte, a posição apropriada do espécime de tecido rápida. Durante o corte, manter a agarose 4% em um banho de água a 55 ° C para se manter em solução. </li><li> Para uma placa de 24 poços para análise secção, adicionar 1 ml de of meio completo (ou seja, de MEM + 10% de soro fetal de bovino 1% + antibióticos) a cada poço. Manter a placa de 24 cavidades à temperatura ambiente (~ 25 ° C) durante toda a duração do seccionamento. </li></ol></li><li> Preparação de Configurações Vibratome <ol><li> Usando o micrótomo vibratório, definir a velocidade a que a lâmina se aproxima da amostra [0 (0,00 mm / seg) a 10 (2,5 mm / seg)] e a frequência da lâmina [0 (0 Hz) a 10 (100 Hz) ]. Ajuste as configurações de acordo com a textura do tecido (ou seja, a densidade / firmeza). </li><li> Para um tumor de mama primário de carcinoma ductal invasivo, ajuste as configurações de 6 e 3, velocidade e freqüência, respectivamente. Para o tecido do tumor menos denso / firme, diminuir a velocidade e aumentar a frequência em conformidade. </li><li> Defina a espessura de corte dentro dos limites do instrumento (1-999 mm). Para estas análises, definir a espessura de corte de 200 m. </li><li> Montar o espécime embebidas em agarose utilizando uma fina camada de cola líquida sobre o disco de amostra that está submerso em um reservatório de mídia que é envolto em gelo molhado. </li></ol></li></ol> 3. Tissue Seccionamento, Tratamento e Análise <ol><li> Remova os cortes cortado com precisão imediatamente após corte usando uma pinça estéril e coloque em um prato multi-bem com 1 ml de meio completo. Quando as secções são adquiridos suficientes para resposta e análises de correlação, colocar a placa de multi-poços de resposta ao tratamento em uma incubadora de cultura de tecido fixado em condições de cultura de tecidos padrão. </li><li> Tire várias secções de controlo que bookend as secções tratadas em um esforço para confirmar a resposta dependente da dose, em oposição aos artefactos cultivadas. Realizar tecido seccionamento rapidamente (~ 30 - 40 min), bem dentro de quaisquer efeitos prejudiciais de tempo de isquemia fria (~ 2-4 hr) 18. Realizar o tratamento de secções só depois de um período de aclimatação de 1 hora. </li><li> Após o período de aclimatação de 1 hora, adicionar (doses terapeuticamente relevante aumentando; <em.&gt; Por exemplo, 0-10 mM concentrações) de drogas para as seções e casa em condições de cultura de tecidos para o período de tratamento. Para este estudo, utilizar períodos de avaliação de 24 horas e / ou 48. No entanto, cortes de tecidos de controle (veículo) só vai permanecer viável, como testado neste estudo, por períodos de até e incluindo os períodos de avaliação de 96 horas. </li><li> Após o tratamento, remover todas as secções em condições estéreis e formalina-fix, colocando a secção de tecido em um tubo contendo quer 10% de formalina tamponada e lugar à TA S / N ou em um tubo contendo paraformaldeído a 4% (16% de paraformaldeído diluir a partir de um frasco com PBS para uma concentração final de 4%) e lugar à temperatura ambiente durante 2 horas. <ol><li> Fixar as secções de tecido maiores (por exemplo,., ~ De 6 mm x 4 mm) de 200 um de espessura em 10% de formalina tamponada O / N à temperatura ambiente. Fix secções menores (por exemplo,. 1 mm x 1 mm) de 200 um de espessura, em 4% de paraformaldeído durante duas horas à temperatura ambiente. NOTA: Para a penetração eficiente de fixador o volume de fixative deve ser 20x o volume do tecido. Dado que este protocolo resulta em tamanhos extremamente pequenos de tecido (por exemplo, de 6 mm de tecido 3 = 6 ul de volume), para garantia de utilização adequada fixação 1 ml de fixador para todos os tamanhos de tecido. </li><li> Após a fixação ter as amostras de tecido embebidas em parafina pelo pessoal do Departamento de Patologia. Seção espécime blocos de parafina em lâminas carregadas ser hematoxilina e eosina e avaliadas por imunohistoquímica (por exemplo, apoptose). </li></ol></li></ol>

<ol>
	<li>Abercrombie, M., Ambrose, E. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interference+Microscope+Studies+of+Cell+Contacts+in+Tissue+Culture.">Interference Microscope Studies of Cell Contacts in Tissue Culture.</a> Experimental Cell Research. 15 (58), 332-345 (1958).</li><li>Coriell, L. L., McAllister, R. M., Wagner, B. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Criteria+for+Determining+Malignancy+in+Tissue-Culture+Cell+Lines+in+the+Albino+Rat.">Criteria for Determining Malignancy in Tissue-Culture Cell Lines in the Albino Rat.</a> New York Academy of Science. 5, 351-355 (1957).</li><li>Paul, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Cancer+Cell+in+Vitro:+A+Review.">The Cancer Cell in Vitro: A Review.</a> Cancer Research. 22, 431-440 (1962).</li><li>Dean, J. L., 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=Therapeutic+response+to+CDK4/6+inhibition+in+breast+cancer+defined+by+ex+vivo+analysis+of+human+tumors.">Therapeutic response to CDK4/6 inhibition in breast cancer defined by ex vivo analysis of human tumors.</a> Cell Cycle. 11 (14), 2756-2761 (2012).</li><li>Bray, 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=Bcl-2+Modulation+to+Activate+Apoptosis+in+Prostate+Cancer.">Bcl-2 Modulation to Activate Apoptosis in Prostate Cancer.</a> Molecular Cancer Research. 7 (9), 1487-1496 (2009).</li><li>Quail, D. F., Joyce, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microenvironmental+regulation+of+tumor+progression+and+metastasis.">Microenvironmental regulation of tumor progression and metastasis.</a> Nature Medicine. 19 (11), 1423-1437 (2013).</li><li>Nakasone, E. S., 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=Imaging+Tumor-Stroma+Interactions+during+Chemotherapy+Reveals+Contributions+of+the+Microenvironment+to+Resistance.">Imaging Tumor-Stroma Interactions during Chemotherapy Reveals Contributions of the Microenvironment to Resistance.</a> Cancer Cell. 21, 488-503 (1016).</li><li>Shi, Y., Hogue, J., Dixit, D., Koh, J., Olson, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+and+genetic+studies+of+isolated+cells+from+parathyroid+tumors+reveal+the+complex+pathogenesis+of+parathyroid+neoplasia.">Functional and genetic studies of isolated cells from parathyroid tumors reveal the complex pathogenesis of parathyroid neoplasia.</a> PNAS. 111 (8), 3092-3097 (2014).</li><li>Vidal, S. J., 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=Isolation+of+cancer+stem+cells+from+human+prostate+cancer+samples.">Isolation of cancer stem cells from human prostate cancer samples.</a> J. Vis. Exp. (85), e51332 (2014).</li><li>Wanping, X., Neckers, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Targeting+the+Molecular+Chaperone+Heat+Shock+Protein+90+Provides+a+Multifaceted+Effect+on+Diverse+Cell+Signaling+of+Cancer+Cells.">Targeting the Molecular Chaperone Heat Shock Protein 90 Provides a Multifaceted Effect on Diverse Cell Signaling of Cancer Cells.</a> Clinical Cancer Research. 13, 1625-1629 (2007).</li><li>Moulick, 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=Affinity-based+proteomics+reveal+cancer-specific+networks+coordinated+by+Hsp90.">Affinity-based proteomics reveal cancer-specific networks coordinated by Hsp90.</a> Nature Chemical Biology. 7 (11), 818-826 (1038).</li><li>Alpaugh, M. L., Tomlinson, J. S., Ye, Y., Barsky, S. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Relationship+of+sialyl-Lewis(x/a)+underexpression+and+E-cadherin+overexpression+in+the+lymphovascular+embolus+of+inflammatory+breast+cancer.">Relationship of sialyl-Lewis(x/a) underexpression and E-cadherin overexpression in the lymphovascular embolus of inflammatory breast cancer.</a> American Journal of Pathology. 161 (2), 619-628 (2002).</li><li>Chu, K., Boley, K. M., Moraes, R., Barsky, S. H., Robertson, F. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+paradox+of+E-cadherin:+role+in+response+to+hypoxia+in+the+tumor+microenvironment+and+regulation+of+energy+metabolism.">The paradox of E-cadherin: role in response to hypoxia in the tumor microenvironment and regulation of energy metabolism.</a> Oncotarget. 4 (3), 446-462 (2013).</li><li>Vaira, V., 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=Preclinical+model+of+organotypic+culture+for+pharmacodynamic+profiling+of+human+tumors.">Preclinical model of organotypic culture for pharmacodynamic profiling of human tumors.</a> PNAS. 107 (18), 8352-8356 (2010).</li><li>Centenera, M. M., Raj, G. V., Knudsen, K. E., Tilley, W. D., Butler, L. 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.

Biólogos câncer enfrentam desafios significativos ao tentar desenvolver estratégias terapêuticas eficazes. Testar medicamentos em desenvolvimento em linhas celulares de cancro estabelecidas não pode refletir com precisão em resposta vivo e in vivo em modelos PDX são trabalhoso e muito caro. Dado o acima, a aplicação de técnicas ex vivo de tumores primários do paciente 14, 15 está agora posicionada ao lado da análise molecular das linhas celulares de cancro e xenoenxerto...

O desenvolvimento de cancro terapêutica eficazes provou ser extremamente desafiador. Linhas de câncer de células tumorais e explantes - bem como enxertos foram usados ​​em pesquisa sobre o câncer há mais de meio século 1,2,3. Até à data, a análise molecular de sensibilidade à droga e resistência em ambas as linhas celulares de cancro e xenoenxertos estabelecidas derivadas de pacientes (PDX) é indispensável. No entanto, o teste de compostos em linhas celulares de cancro estabelecidas muitas vezes não é de previsão de eficácia in vivo, e estudos in vivo correspondente em animais, especialmente em modelos de PDX, é muito cara e demorada. As limitações destes sistemas modelo, ou seja, a incapacidade para informar sobre a influência do microambiente nativo em progressão do tumor e a resposta de estratégias terapêuticas, levou o campo de investigação para o desenvolvimento de métodos adicionais para complementar estas análises. De recente, maior atenção está sendo pago para ex vivo de análise de tum pacienteou explantes 4, 5, devido à maior compreensão de que a resposta terapêutica do câncer não é exclusivo para a composição molecular inerente das células cancerosas mas é muito influenciada pelo microambiente celular tumor 6, 7 um recurso que não pode ser reproduzido por meio de métodos e de cultivo tradicionais / ou PDX. análise ex vivo, no contexto acima (ie., influência do microambiente adjacente célula tumoral circundante) implica a avaliação de seções tumor / metástase de primário viáveis, ao invés de ex vivo de análise de isolados celulares 8, 9. Registramos aqui uma técnica ex vivo (ie., Seções cortado com precisão frescas de tecidos) de ambos os tumores primários de pacientes e metástases associadas (ou seja, os gânglios linfáticos), que informa fielmente na resposta (IC50), efeitos fora do alvo e permite molecular análise dos mecanismos de resistência e de feedback. Além disso, uma análise correlativa de therapeUTIC sensibilidade / resistência contra biomarcador e perfil de expressão do gene pode ser realizada em um esforço para identificar os pacientes com maior probabilidade de responder à droga experimental de interesse (ou seja., resposta de droga elevada corresponde paciente com particular perfil biológico). Aplicação da técnica ex vivo e avaliação de uma forma multi-parâmetro é movimento para a seleção dos pacientes e melhoria global dos resultados clínicos. Análise ex vivo da resposta ao tratamento pode se tornar uma ferramenta padrão no desenvolvimento pré-clínico e clínico da terapêutica do câncer e é visto como um passo em direção a uma abordagem da medicina personalizada em estratégias de desenvolvimento de terapias.

<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.

Para este estudo, a técnica ex vivo foi utilizado na análise de um correlativo de terapêutica sensibilidade / resistência de um inibidor da proteína de choque térmico 90 (Hsp90i). Em uma avaliação pré-clínica deste Hsp90i, o tumor primário de câncer de mama, um ER + ductal carcinoma invasivo (IDC), e associado metástases em linfonodos foram analisados ​​ex vivo para a resposta ao tratamento &#160; (Figura 1). Vários 200 mM cortes seriados foram tratad...

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

Linhas celulares de cancro estabelecidos e xenotransplantes têm sido o esteio da pesquisa do câncer para as últimas décadas. No entanto, evidências recentes sugerem que a resposta terapêutica é muito influenciada pelo microambiente de células tumorais. Portanto, foi desenvolvida uma análise ex vivo de amostras de tumor primário para fins de desenvolvimento de drogas.

Ex Vivo resposta ao tratamento de tumores primários e / ou Associated Metástases para pré-clínica e clínica de Desenvolvimento 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 visualizações.  Memorial Sloan Kettering Cancer Center.  Linhas celulares de cancro estabelecidos e xenotransplantes têm sido o esteio da pesquisa do câncer para as últimas décadas. No entanto, evidências recentes sugerem que a resposta terapêutica é muito influenciada pelo microambiente de células tumorais. Portanto, foi desenvolvida uma análise ex vivo de amostras de tumor primário para fins de desenvolvimento de drogas. 

Vídeo: 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.

Ablação térmica para o tratamento de tumores abdominais

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

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.

Monitoramento metástases tumorais e lesões osteolíticas com bioluminescência e CT Micro Imagem

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.

A Novel de alta resolução<em&gt; In vivo</em&gt; Técnica de Imagem para estudar a resposta dinâmica de estruturas intracranianas ao crescimento do tumor e Terapêutica

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.

Adaptação do Semi-Automática de circulação Tumor de Células (CTC) Ensaios para aplicações clínicas e pré-clínica de Pesquisa

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.

Um Modelo murino de metástases hepáticas pré-clínica

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.

Isolado hepática Perfusão como um tratamento para o fígado Metástases de Uveal Melanoma

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.

Geração de Microtumors Usando 3D Biogel Humano Sistema de Cultura e células de glioblastoma derivado do paciente para Kinomic Profiling e Testes resposta à droga

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.

Avaliação de Alternância Espontânea, Reconhecimento de Objetos Novos e Clasping de Membros em Modelos de Rato Transgênico de Neuropatologia Amilóide-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.

Tratamento de metástases hepáticas, usando um método do Volume alvo interno para radioterapia estereotáxica 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.

Contrações do citoplasma de casos humanos-iPSC-derivado medida com um corante fluorescente de Ca-sensíveis em placas de 384 poços de temperatura controlada

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