2016年9月15日，美国癌症研究协会官方期刊《癌症研究》正式发表阿拉巴马大学、密歇根大学、明尼苏达大学、西北大学、科罗拉多大学的研究，报告了一种小型可植入装置，将其植入到皮肤下面即可通过捕获乳腺癌细胞提高乳腺癌患者的生存率，延缓发生转移的乳腺癌细胞在其他器官中的生长过程，为手术和其他干预手段争取时间。该研究为提早发现乳腺癌细胞转移，制定干预措施提高治疗效果提供了一条新途径。
该研究是对既往研究成果的进一步扩展，表明该植入装置可以有效捕获发生转移的乳腺癌细胞，证明在乳腺癌转移出现明显症状之前进行手术能够改善生存情况。
该可植入支架装置使用美国FDA批准的生物可降解材料微孔聚（ε-己内酯）制成，该材料常用于制造手术缝合线以及伤口敷料。该支架装置能够模拟乳腺癌细胞转移之前其他器官的环境，首先吸引免疫细胞聚集，随后免疫细胞又会招来乳腺癌细胞。通过该方式限制免疫细胞到达肺，肝脏以及脑等容易形成乳腺癌转移灶的器官。
免疫细胞最初通常在转移灶聚集，为乳腺癌细胞向该器官扩散营造合适环境。该研究结果表明将免疫细胞吸引到支架装置可以限制这些免疫细胞为乳腺癌细胞营造转移环境的能力。支架中聚集的免疫细胞越多，就会将越多乳腺癌细胞吸引到该人工环境。
该系统可以进行乳腺癌转移的早期检测和治疗，但是无法治愈乳腺癌。这个可植入的支架装置不能阻止乳腺癌转移，对于那些已经发生转移的患者也无法逆转乳腺癌进展，。
研究者将进行临床试验利用该系统监视乳腺癌细胞转移，也希望未来能够用于乳腺癌高风险人群的监测。
Cancer Res. 2016 Sep 15;76(18):5209-18.
Enhanced Survival with Implantable Scaffolds That Capture Metastatic Breast Cancer Cells In Vivo.
Rao SS, Bushnell GG, Azarin SM, Spicer G, Aguado BA, Stoehr JR, Jiang EJ, Backman V, Shea LD, Jeruss JS.
University of Alabama, Tuscaloosa, Alabama; University of Michigan, Ann Arbor, Michigan; University of Minnesota, Minneapolis, Minnesota; Northwestern University, Evanston, Illinois; University of Colorado, Boulder, Colorado.
The onset of distant organ metastasis from primary breast cancer marks the transition to a stage IV diagnosis. Standard imaging modalities often detect distant metastasis when the burden of disease is high, underscoring the need for improved methods of detection to allow for interventions that would impede disease progression. Here, microporous poly(ε-caprolactone) scaffolds were developed that capture early metastatic cells and thus serve as a sentinel for early detection. These scaffolds were used to characterize the dynamic immune response to the implant spanning the acute and chronic foreign body response. The immune cell composition had stabilized at the scaffold after approximately 1 month and changed dramatically within days to weeks after tumor inoculation, with CD11b(+)Gr1(hi)Ly6C(-) cells having the greatest increase in abundance. Implanted scaffolds recruited metastatic cancer cells that were inoculated into the mammary fat pad in vivo, which also significantly reduced tumor burden in the liver and brain. Additionally, cancer cells could be detected using a label-free imaging modality termed inverse spectroscopic optical coherence tomography, and we tested the hypothesis that subsequent removal of the primary tumor after early detection would enhance survival. Surgical removal of the primary tumor following cancer cell detection in the scaffold significantly improved disease-specific survival. The enhanced disease-specific survival was associated with a systemic reduction in the CD11b(+)Gr1(hi)Ly6C(-) cells as a consequence of the implant, which was further supported by Gr-1 depletion studies. Implementation of the scaffold may provide diagnostic and therapeutic options for cancer patients in both the high-risk and adjuvant treatment settings.
PMID: 27635043
DOI: 10.1158/0008-5472.CAN-15-2106
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