CTC profiling of PD-L1, HER2, and EGFR guides targeted cancer therapies. Publications | April 19, 2023 AACR 2023: Detection of PD-L1, HER2 and EGFR on circulating tumor cells in carcinoma patients. CTC analysis in 134 patients successfully detected PD-L1, HER2, and EGFR, proving its value as a real-time guide for targeted therapies. Background Small molecular inhibitors and immunotherapy have emerged as a novel alternative treatment regime for a variety of epithelial cancers. A large number of clinical trials are in progress worldwide to gauge the efficacy of tyrosine kinase inhibitors (TKI) or immune checkpoint inhibitors (ICI) against actionable targets such as receptor tyrosine kinases (RTKs) and program death ligand 1 (PD-L1). Although highly effective, the outcome of PD-L1 based ICI or TKI against RTKs is vitally contingent on the presence of PD-L1 or RTK expression on cancer cells. Determining druggable targets on the basis of solid biopsy could be often misleading, especially if a patient has progressed in spite of chemotherapy. This could be due to the intrinsic heterogeneity of tumor cells or therapeutic selection pressure or both, leading to alteration in the expression profile of the targets. Additionally, the immunohistochemistry result depends on a multitude of quality controls such as age and integrity of a biopsy sample, lab-to-lab variations in tissue block preparation, and degradation of targets due to chemical fixation methods. This unmet need of reliable detection and monitoring of actionable target expression could be addressed by circulating tumor cells (CTCs) based liquid biopsy tests. To this end, we have developed a CTC-based liquid biopsy assay to detect PD-L1, HER2, and EGFR expression in different epithelial cancers. Methods We retrospectively evaluated peripheral blood samples from a total of 134 carcinoma patients for the presence of CTCs expressing PD-L1, HER2, or EGFR markers respectively. Among these, 45% of patients had lung cancer, while 25% and 20% presented with breast, GI, and colorectal (CRC) malignancies. The remaining were gall bladder, ovarian, prostate, and head and neck cancer (HNC) patients. All lung cancer patients were analyzed for CTCs expressing PD-L1. CTCs were isolated from DCGI-approved OncoDiscover technology based on immunomagnetic targeting of epithelial cell surface molecules (EpCAM). EpCAM-targeted, magnetically isolated cells were considered CTCs on the basis of expression of cytokeratins, absence of CD45, and prominent presence of DAPI-stained nuclei. The presence or absence of aforesaid markers was determined using automated fluorescence imaging. Expression of PD-L1, HER2, or EGFR was detected by fluorescence microscopy using fluorescently labeled anti-PD-L1, HER2, or EGFR antibodies respectively. Based on fluorescence intensity, CTCs were binned as PD-L1, HER2, or EGFR negative for no detectable fluorescence signal, or weakly or strongly positive based on low or high fluorescence signal. Results Among the evaluated cohort, 51% of all CTCs showed the presence of PD-L1 expression, while 63% showed HER2-positive CTCs (all from breast cancer patients). 20% from the PD-L1 positive population showed strong PD-L1 expression. 78% of CTCs from lung cancer patients showed the presence of a detectable PD-L1 signal, while 66% of breast, GI, and CRC patients showed CTCs with PD-L1 expression. CTCs from HNC and gall bladder cancer patients showed the least PD-L1 expression (25% and 50% respectively). Among CTCs originating from different cancer types, breast cancer CTCs showed higher mean expression of PD-L1 compared to CTCs from colorectal cancer patients. A clear subset of CTCs for PD-L1 and HER2 expression was observed in lung and breast cancer patients respectively, suggesting heterogeneity in expression or the presence of different subclones within the same tumor type. Among all CTCs evaluated for EGFR expression, 50% showed the presence of detectable EGFR compared to the cut-off value. Conclusions CTCs isolated from cancers of epithelial origin showed the presence of PD-L1. Similarly, CTCs obtained from breast and lung cancer patients showed HER2 and EGFR expression respectively. Our data suggest that CTCs can be used as a real-time surrogate for molecular profiling of PD-L1, HER2, and EGFR expression, besides being a prognostic marker. Detection of PD-L1, HER2, and EGFR in CTCs offers a potential and viable alternative for immunotherapy or targeted therapy decisions in a vast majority of epithelial cancers. Know more Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

CTC monitoring detects early HNSCC in chronic tobacco users in Bangladesh. Publications | June 8, 2021 ASCO 2021: CTCs demonstrate a positive biomarker in head and neck squamous cell carcinoma (HNSCC) in tobacco consuming population of Bangladesh. A study in Bangladesh found CTCs in 64% of HNSCC patients with chronic tobacco history, suggesting CTCs as a screening tool for early cancer detection. Background Tobacco consumption accounts for 1.6 million deaths annually in the South East Asia Region (SEAR). Notably, amongst the 10-20% of the global population consuming betel quid and tobacco, about an 81% concentration is in SEAR regions, including India and Bangladesh. The prevalence of HNSCC in these regions is rising alarmingly. For example, HNCs account for 23% of the total 156,775 cancer incidences in Bangladesh. Liquid biopsy tools are unavailable and expensive for most patients in this region. However, early cancer detection using tumor biomarkers, for example, circulating tumor cells (CTCs), is highly implicated. Furthermore, such biomarkers are being validated and have the potential for screening high-risk patients, such as those with a genetic predisposition or tobacco consumption. We report the first observational study in HNSCC patients in Bangladesh correlating the presence of CTCs to chronic tobacco consumption. Methods The study involved 70 cancer patients and 10 healthy volunteers (no prior cancer history). 87% of the patients had a specified history of chronic tobacco consumption. CTCs were isolated in 1.5 ml of blood using the OncoDiscover Liquid Biopsy Test, which is clinically approved by the Drug Controller General of India, and contains an enriching anti-EPCAM antibody immunomagnetic kit. CTCs are qualified as CK18+, DAPI+, and CD45-. Subsequently, CTCs were imaged using a Zeiss Axio Observer 7 and quantified for Mean Fluorescence Intensity (MFI) for clinicopathological parameters: age/gender, HNSCC sub-population, and CTC distribution. Results This is the 1st study on the Bangladesh phenotype accounting for the presence of CTCs in HNSCC patients. In this population, 34 males (66%) and 10 females (52%) accounted for 91 CTCs. CTC distribution was 0 to 6 with a mean and median of ~ 2.02 and 2, respectively. 25 patients (17 males, 8 females) were negative for any CTCs. Interestingly, 2 patients exhibited CTC clusters indicative of aggressive metastasis, in which 1 patient had no prior tobacco usage or family cancer history. There was no correlation between CTC presence in males (66%) and females (52%). Healthy volunteer samples exhibited no false positives. The MFI values ranged between 23 and 766, with mean and median MFI values of 157 and 96, respectively, indicative of CK overexpression on CTCs of HNSCC patients. Conclusions HNSCC patients with a history of chronic tobacco consumption in Bangladesh correlated with the presence of CTCs in 64% of the cases. Prospectively, CTCs may be validated as a biomarker for screening chronic tobacco users in Bangladesh to detect early cancers and HNSCC. Clinical Trial Information BMRC/Grants/2018/99 (1-100). Know more Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

CTCs, clusters, and PD-L1 expression indicate MRD and guide endometrial cancer care. Publications | November 3, 2025 PD-L1 over-expression on Circulating Tumor Cells in Endometrial Cancer Patients Khandare J, Ghadyalpatil N, Raja T, Velukuru S, Jadhav V, Satape R, Shinde S, Ashturkar A, Dattatreya P, Vasudevan A Actorius Innovations And Research, Pune, Maharashtra, India; Apollo Cancer Institute, Hyderabad, Telangana, India; Apollo Cancer Centre, Chennai, Tamil Nadu, India; Aster CMI Hospital, Bangaluru, Karnataka, India; Renova Soumya Cancer Center, Hyderabad, Telangana, India. Introduction The risk of recurrence in non-metastatic endometrial cancer (EC) within 2–3 years is significant, ranging from 6% to 21%. Lymph node involvement is a key determinant of outcome prediction in patients with operable EC. To improve prognostic accuracy, particularly in the context of curative-intent surgery and adjunct therapy regimens, biomarkers such as circulating tumor cells (CTCs) have not been extensively evaluated in EC. The presence of CTCs as an occult disease component in EC may represent minimal cellular residual disease (MCRD) and could play a role in the metastatic cascade and invasion to distant organs. In this study, we evaluated the distribution of CTCs, their PD-L1 overexpression, and the occurrence of CTC clusters in EC patients. Methods A total of 154 blood samples were retrospectively analyzed, including 133 baseline and 21 follow-up samples (1.5 mL each). CTCs were isolated using the CDSCO India–approved OncoDiscover® CTC Test, which employs immunomagnetic enrichment targeting epithelial cell adhesion molecule (EpCAM). CTCs were identified based on immunocytochemical staining as CK18⁺, DAPI⁺, and CD45⁻ cells with distinct morphological features. Fluorescence imaging was performed using a Zeiss Axio Observer 7 microscope, and signal intensities were quantified to assess associations with clinicopathological parameters. PD-L1 expression on CTCs was evaluated through fluorescence-based immunostaining and quantified accordingly. Statistical analyses summarized total CTC counts, PD-L1–positive CTCs, and the presence of CTC clusters. Results A total of 336 CTCs were detected in 116 patients (75.3%). PD-L1 overexpression on CTCs was observed in 52.6% of samples (81 out of 154). Across all 154 patient samples analyzed, the mean values were 1.54 for total CTCs, 0.14 for CTC clusters, and 1.23 for PD-L1–positive CTCs. Notably, 21 patients (13.6%) demonstrated the presence of CTC clusters, accounting for 121 of the 336 total CTCs, suggesting more aggressive disease behavior. The highest proportion of patients belonged to the 61–70-year age group (41.55%). Conclusions This study demonstrates a high prevalence of CTCs in the endometrial cancer population. The presence of CTCs, CTC clusters, and PD-L1–overexpressing CTCs indicates occult minimal residual disease, disease aggressiveness, and potential progression toward metastasis. PD-L1 expression on CTCs may have implications for immunotherapy decision-making, particularly in situations where tissue biopsy is unavailable. View Publication Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

CTCs track progression across early-stage breast cancer molecular subtypes. Publications | June 6, 2023 ASCO 2023: Circulating tumor cells (CTCs) detection and isolation in different subtypes of early-stage breast cancer patients from Bangladesh. A trial found CTCs in 60% of early-stage breast cancer patients, notably all HER2-positive cases, linking them to tumor grade. Send the next! Background Breast cancer is a highly heterogeneous pathophysiology characterized by poor outcomes. Due to the increasing incidence and disease progression rates and undefined relapse periods, reliable disease monitoring is a challenge and has remained an unmet need. Advancements in liquid biopsy have significantly enhanced our understanding of clinical oncology. CTC-based liquid biopsy is emerging as a reliable prognostic tool to predict various clinical indicators. Although extensively investigated in metastatic breast cancers, little is known about CTCs in early-stage breast cancers. CTCs with respect to different molecular subtypes of breast cancer in early-stage breast cancer patients is evaluated. Methods In this prospective clinical trial (CMC 59.27.0000.013.19 PG.009.2022/262), 40 early-stage patients with luminal (A + B, 33.33%), HER2-positive (12.8%), triple-negative (12.8%), and undetermined (41.07%) subtypes were recruited. CTCs were isolated in 1.5 ml blood using the Drug Controller General of India approved OncoDiscover CTC test. This platform contains affinity-based magnetic nanoparticles to mediate EpCAM-based CTC isolation. CTCs were detected as CK18+, DAPI+, and CD45- cells using a fluorescence detection-based automated digital imaging platform. Results CTCs were detected in 60% of patients with a mean CTC count of 1 cell / 1.5 ml blood. Among total positive patients, the luminal subtype was the least positive (46%), followed by TNBC (60%) and undetermined (62.5%) subgroups, while all HER2-positive patients showed the presence of CTCs. Besides individual cells, CTC clusters were detected in 12.5% of patients, and they were equally distributed in luminal and HER2-positive subpopulations. When analyzed on the scale of tumor grade, grade I patients did not show the presence of CTCs, while 58.33% of grade II patients had ≥ 1 CTC. All grade III patients showed the presence of ≥ 1 CTC. CTC count was high among CTC-positive grade II patients (average 2 CTCs) and correlated well with the presence of CTC clusters in these patients. Patients who had surgical intervention had a low CTC burden compared to patients who did not have a surgical resection. 75% of treatment-naive patients showed the presence of CTCs, while 58% of patients receiving chemotherapy alone showed the presence of 1 CTC. 50% of patients who had surgery followed by CT + RT showed the presence of 1 CTC. Conclusions The presence of CTCs may suggest the biological progression of disease in early-stage BC patients. CTCs detected in all HER2-positive patients suggested the high shedding nature of these tumors, which correlates well with their reported migratory tendency. The presence of CTCs did not show a clear correlation with the treatment regimen. However, this data is based on a single time point and needs longitudinal correlation with CTCs on a larger sample size. Clinical Trial Information 59.27.0000.013.19 PG.009.2022/262. Know more Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Making cancer detection more accessible and affordable to people Press Release | August 24, 2019 Startup Mantra: Making cancer detection more accessible and affordable to people Launching ‘OncoDiscover Liquid Biopsy Test’, a minimally invasive test which can be performed multiple times requiring 1.5ml blood volume... Actorius Innovations and Research Pvt. Ltd. Read full release Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

CTCs and PD-L1 in sarcoma indicate minimal residual disease and need for monitoring. Publications | May 9, 2025 Accounts of circulating tumor cells and CTC clusters with PD-L1 expression in sarcoma patients Study shows circulating tumor cells with PD-L1 expression and clusters in sarcoma, indicating minimal residual disease and need for long-term monitoring. Abstract Background: Sarcomas are characterized by significant heterogeneity, diverse histological subtypes, and variable clinical behavior. Dynamic epithelial-to-mesenchymal transition (EMT) processes in solid tumors contribute to disease aggressiveness. Characterization of circulating tumor cells (CTCs) in sarcomas remains challenging due to the lack of well-defined, cell-specific markers and limited molecular characterization. Compared with adenocarcinomas, studies on sarcoma-derived CTCs are relatively limited. Therefore, isolation and characterization of CTCs, including assessment of protein expression and cellular transitions using affinity ligands such as anti-epithelial cell adhesion molecule (EpCAM) antibodies, may improve clinical outcomes in sarcoma patients. The role of CTCs as minimal cellular residual disease (MCRD) is particularly relevant post-treatment, including after curative-intent surgery. Objective: To evaluate the prevalence of CTCs and CTC clusters as indicators of minimal cellular residual disease (MCRD), along with PD-L1 expression, in sarcoma patients. Methods: In this retrospective study, peripheral blood samples from 97 sarcoma patients (55.95% male and 44.05% female) were analyzed for the presence of CTCs, PD-L1 expression, and CTC clusters. CTCs were isolated using the OncoDiscover platform approved by CDSCO from 1.5 mL of blood. The platform utilizes a multifunctional magneto-nanosystem mediated by anti-EpCAM antibodies. CTCs were identified as EpCAM⁺, CK18⁺, DAPI⁺, and CD45⁻ cells. PD-L1 expression on CTCs was quantified based on linear fluorescence intensity gradients using image acquisition on an automated Zeiss microscope. Results: Among the 97 patients, 86.59% had baseline CTC assessments, while 13.40% had follow-up samples. At baseline analysis, 68.04% (n = 66) of patients demonstrated ≥1 CTC per 1.5 mL of blood. The CTC count ranged from 1 to 6 cells, with a mean value of 1.17. Additionally, 61.44% (n = 51) of patients with detectable CTCs exhibited PD-L1 expression, with a mean value of 0.92. The highest proportion of CTCs (31.11%, n = 28) and CTC clusters (6.14%, n = 7) was observed in the 31–40-year age group. Conclusions: The presence of CTCs with CTC clusters and PD-L1 expression suggests minimal cellular residual disease (MCRD) and may indicate aggressive disease behavior in sarcoma patients. Following treatment, the detection of such CTCs may be associated with metastasis progression. Therefore, longitudinal monitoring of these patients is recommended to support improved clinical outcomes. View Publication Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

CTC counts correlate with OSCC stage and aggressive pathological features in India. Publications | March 15, 2020 ASCO 2020: Correlation of CTCs with disease progression in Indian oral cancer patients. In 230 OSCC patients, CTC counts correlated with cancer stage and aggressive features, proving CTCs are a reliable marker for disease stratification. Background Head and neck squamous cell carcinoma is the leading cancer in India, with oral squamous cell carcinoma (OSCC) as the most frequent subtype. OSCC is classified as a locoregional disease, and its increased frequency is attributed to a lack of effective biomarkers compared to other epithelial cancers. At the time of diagnosis, above 50% of cases present with advanced-stage disease and are predisposed to treatment failure despite appropriate intervention. Thus, early diagnosis of OSCC can significantly reduce the disease burden. Here, we describe a regulatory-approved method to establish the presence of circulating tumor cells (CTCs) in Indian OSCC patients and its positive correlation with various clinicopathological parameters, suggesting the potential use of CTCs as a significant parameter to stratify oral cancer with respect to disease advancement. Methods In a cross-sectional observational study, 230 OSCC patients at different pathological stages of the disease and treatment modes were enrolled. CTCs were isolated using the approved OncoDiscover liquid biopsy technology (approved by the Drug Controller General of India), a platform based on immunomagnetic CTC enumeration. CTCs were detected for CK18 presence and well-defined, DAPI-stained nuclei. Enumerated CTCs were subsequently analyzed for various clinicopathological parameters such as pathological stage (pStage), extra-capsular spread (ECS), lymphovascular emboli (LVE), perineural invasion (PNI), and depth of invasion (DOI). CTC cut-off values were obtained to differentiate early vs. advanced stages with respect to different clinical stages and parameters. Results CTCs of OSCC patients correlated positively with cancer stages (clinical as well as pathological) as well as aggressive pathological features. In the presence of aggressive pathological features that often suggest a poor disease outcome, we observed a 25–50% increase in CTC numbers. Early-stage, treatment-naive patients had a lower number of CTCs. The mean CTC number in advanced-stage patients was 50% higher than in early-stage OSCC patients. Conclusions Considering the positive correlation of CTC numbers with various pathophysiological features, CTCs can be contemplated as a reliable parameter to predict disease outcome in oral cancer. The consistent presence of CTCs across all disease stages also suggests the probable nature of OSCC as a biological systemic disease. Clinical Trial Information CTRI/2018/03/012905. Know more Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Actorius Innovations at ASCO Annual Meeting 2026 Publications | March 17, 2026 ASCO 2026 : Association of circulating tumor cells with PD-L1 expression and clusters in confirmative tumor thrombus in selective solid cancers. Study shows circulating tumor cells with PD-L1 expression in tumor thrombus patients, indicating active dissemination and potential metastatic risk. Abstract Background Tumor thrombus (TT) refers to the direct extension of tumor cells into a blood vessel and is often detected incidentally. It is commonly observed in renal cell carcinoma (RCC), hepatocellular carcinoma (HCC), and Wilms tumor. The presence of TT significantly worsens prognosis and alters disease staging. TT is frequently located in vessels such as the renal vein, inferior vena cava, and portal vein, requiring multidisciplinary evaluation due to its aggressive nature and risk of obstruction or embolization. Diagnostic differentiation between tumor thrombus and a “bland” thrombus (blood clot) typically relies on imaging techniques such as CT or MRI. In this study, we evaluated the association and potential role of circulating tumor cells (CTCs) expressing immune-relevant markers, such as PD-L1, in patients with tumor thrombus. The presence of CTCs originating from TT margins may help refine risk stratification and therapeutic decision-making. Methods In this observational study, 12 patients aged 51–80 years with confirmed tumor thrombus were analyzed. The cohort included patients with hepatocellular carcinoma (HCC, n = 4), pancreatic cancer (n = 3), liver cancer (n = 3), renal cell carcinoma (RCC, n = 1), and gallbladder cancer (GB, n = 1). Blood samples were analyzed for the presence of CTCs with PD-L1 expression at baseline, and three patients also had follow-up samples. Samples were processed using the CDSCO-approved OncoDiscover CTC enrichment technology. CTCs were identified using an automated Zeiss microscope based on EpCAM⁺, CK18⁺, DAPI⁺, CD45⁻, and PD-L1⁺ markers. Results A total of 16 CTCs were detected in 10 patients (83.33%) from 1.5 mL blood samples, with counts ranging from 1 to 6 CTCs per patient. At baseline, patients with HCC, pancreatic, RCC, gallbladder, and other cancers showed the presence of PD-L1–expressing CTCs. Follow-up samples revealed persistent CTC positivity, although the number of PD-L1–positive CTCs decreased. The mean CTC distribution was 1.33 for CK18-expressing CTCs. PD-L1–positive CTCs were detected in a substantial subset, with a mean distribution of 0.67 (9 CTCs among 12 patients), indicating immune-evasive potential. CTC clusters were rare and detected in only one HCC patient but persisted during follow-up. Both male and female patients demonstrated comparable CTC positivity. Conclusion The presence of CTCs in peripheral blood highlights active tumor cell dissemination from tumor thrombus margins. Although CTC clusters were infrequent, their occurrence may indicate an increased metastatic risk. This study demonstrates, for the first time, the presence of CTCs originating from tumor thrombus margins entering systemic circulation. Further studies are required to better understand their clinical implications. View Publication Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

CTCs and PD-L1 profiling support MRD detection and therapy decisions in ovarian cancer. Publications | June 3, 2024 ASCO 2024: Effect of circulating tumor cells (CTC) and CTC clusters with PD-L1 dynamic biomarker on cellular burden in patients with ovarian cancer. CTCs with PD-L1 expression in ovarian cancer reveal minimal residual disease and may guide immunotherapy and early metastasis monitoring. Background In the precision oncology era, monitoring treatment response using circulating blood-based biomarkers such as circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) is rapidly being evaluated and established. The leading cause of mortality in ovarian cancer patients is delayed diagnosis and the inability to effectively select patients for targeted therapies, including immune checkpoint blockade (ICB) agents. Treatment for ovarian cancer usually involves a combination of surgery and chemotherapy. However, postoperative resection and therapy with curative intent often fail to account for minimal cellular disease (MCD). The dissemination of circulating tumor cells (CTCs) represents minimal residual disease (MRD), which may diffuse and cause micro-metastasis through epithelial-to-mesenchymal transition (EMT) and bio-mechanistic activation in blood circulation. Simultaneous detection of overexpression of programmed death-ligand 1 (PD-L1) on CTCs as a dynamic biomarker may be useful for assessing patients for immune checkpoint inhibitor (ICI) therapy. Methods In a retrospective analysis of real-world data, peripheral blood samples from 75 ovarian cancer patients were analyzed for the presence of CTCs, with and without PD-L1 expression, and for the presence of CTC clusters. CTCs were detected using the CDSCO-approved OncoDiscover platform from 1.5 ml of peripheral blood. The platform is a multifunctional magneto-nanosystem mediated by anti-epithelial cellular adhesion molecule (EpCAM) antibodies. CTCs were identified as positive when EpCAM+, CK+, PD-L1+, DAPI+, and CD45- markers were present. PD-L1 expression on CTCs was analyzed based on the linear intensity gradients of fluorescence signals using image acquisition on an automated Zeiss microscope. Results Baseline sample analysis showed that 86% (n = 65) of patients had at least one CTC per 1.5 ml of blood. The CTC distribution ranged from 1 to 9 CTCs. Among the patients with CTCs, 46.15% (n = 30) showed PD-L1 expression. Notably, the highest number of CTCs (~26.7%, n = 23) was observed in the 41–50 age group. Additionally, 8% (n = 6) of the total patients showed the presence of CTC clusters. The presence of CTCs with PD-L1 expression and CTC clusters did not show a correlation with factors such as staging, follow-ups, metastasis, or disease-free survival (DFS) status. Conclusions We observed the presence of minimal cellular disease (MCD) and minimal residual disease (MRD) in ovarian cancer patients despite treatment with curative intent. Detection of CTCs, CTC clusters, and PD-L1 overexpression as real-time dynamic biomarkers may help assess early metastasis, disease progression, and regression. These biomarkers may also support the selection of patients suitable for immune checkpoint inhibitor (ICI) therapy when tissue samples are inadequate or unavailable, potentially improving clinical outcomes. Know more Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Actorius Innovations at AACR 2026 Publications | March 17, 2026 AACR 2026: Over expressing PD-L1 circulating tumor cells with clusters in prostate cancer patients Study shows high prevalence of PD-L1–positive circulating tumor cells in prostate cancer, highlighting their value for monitoring disease progression and immune evasion. Abstract Background Prostate cancer (PC) detection remains challenging due to the limited specificity and sensitivity of current screening methods, including PSA testing. PSA testing does not reliably distinguish aggressive disease from indolent forms, often leading to overdiagnosis and overtreatment. Circulating tumor cells (CTCs), however, offer greater clinical value by providing real-time insights into tumor biology, disease progression, and treatment response. Unlike PSA, CTCs represent a dynamic biomarker reflecting systemic minimal cellular residual disease (MCRD), which can support monitoring and guide personalized prostate cancer management. In addition, the overexpression of PD-L1 on CTCs provides insight into immune evasion mechanisms and may have predictive and prognostic value in prostate cancer. In this study, we report the capture of CTCs, including PD-L1–positive cells and CTC clusters, in prostate cancer patients. Methods A retrospective analysis was conducted on 239 prostate cancer patients to evaluate the presence of PD-L1–positive CTCs and CTC clusters. The cohort included 216 (90.4%) baseline samples and 23 (9.6%) follow-up samples. CTCs were isolated using the CDSCO-approved OncoDiscover Test (India), which employs anti-EpCAM antibody–based immunomagnetic enrichment from 1.5 mL of blood. CTCs were identified as CK18⁺/DAPI⁺/CD45⁻ cells with PD-L1 expression and distinct morphology. Automated fluorescence imaging was used to quantify signal intensities and correlate them with clinicopathological parameters. Patients were stratified by age, and quantitative analyses of CTC positivity, PD-L1 expression, and CTC cluster frequency were performed. Results CTCs were detected in 173 patients (72.4%), while 66 patients (27.6%) were CTC-negative. Among 157 evaluable samples for PD-L1 expression, 131 (54.8%) were PD-L1 positive and 26 (10.9%) were negative. CTC clusters were observed in 19 patients (11%), while 154 patients (89%) exhibited only single CTCs. At baseline, CTCs were detectable in 70.4% of patients, increasing to 91.3% in follow-up samples. PD-L1–positive CTCs were observed in 52.3% of patients at baseline and 85.7% at follow-up. Additionally, PD-L1–positive CTC clusters increased from 10.5% at baseline to 13.1% at follow-up. The predominant age groups were 61–70 years (39.0%) and 71–80 years (39.9%), together comprising nearly 80% of the cohort. The mean distribution of CTC counts per patient was 1.14 for total CTCs, 0.95 for PD-L1–positive CTCs, and 0.12 for CTC clusters. Conclusion A high prevalence of CTCs and PD-L1 expression was observed among prostate cancer patients, particularly in older age groups. The detection of PD-L1–positive CTCs highlights the presence of confirmatory MCRD and circulating disease. Although the incidence of CTC clusters was relatively low, their presence may indicate more aggressive disease phenotypes. View Publication Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

EMF triplet therapy and CTC monitoring improve HNSCC outcomes and predict response. Publications | June 7, 2022 ASCO 2022: A feasibility study of EMF (erlotinib+methotrexate+5-fluorouracil) regimen in recurrent HNSCC and role of CTCs in assessment of outcomes. A phase II trial shows EMF triplet therapy is a safe, effective option for HNSCC, with CTCs serving as a promising biomarker for therapy response. Background Head and neck cancer is a huge burden in South East Asia with frequent relapse after curative therapy, while the rest present in advanced unresectable stages. Financial constraints for targeted and immunotherapy make it inaccessible for the bulk of the population. Thus, a low-cost but efficacious regimen is highly implicated. We assessed if the readily available triplet therapy of EMF is superior in terms of extending life and maintaining quality of life, along with the evaluation of CTCs as a predictive biomarker in such patients. Methods This was a single-arm, phase II, investigator-initiated interventional study, wherein 35 patients were enrolled. Platinum-resistant/refractory patients of HNSCC were treated with a combination of erlotinib 150 mg daily, methotrexate 40 mg/m2, and 5-fluorouracil 500 mg/m2 (d1, d8) q28 days till progression or unacceptable toxicities. The primary endpoint was the overall response rate (ORR) at 3 months; additional endpoints were disease control rate (DCR) at 3 months, overall survival (OS), progression-free survival (PFS), safety, and patient-reported quality of life (QOL). The role of CTCs in gauging the responders and non-responders was monitored using anti-Epithelial Cell Adhesion Molecule antibody-based enrichment on the OncoDiscover Drug Controller General of India (DCGI) approved platform. Results The ORR and DCR at 3 months were 45.7% and 68.5%, respectively. The median PFS was 5 months (95% CI: 3.9-6 months) and median OS was 9 months (95% CI: 7.4-10.5 months). The 3- and 6-month PFS rates were 86 ± 6% and 45 ± 9%, respectively, while OS rates at 3 and 6 months were 91 ± 5% and 68 ± 8%, respectively. Rash, mucositis, and fatigue were common adverse events occurring in 23 (65%), 14 (40%), and 9 (25.7%) patients respectively. The grade 3 events seen were rash in 5 (14.2%) and diarrhea in 2 (5.7%). Clinically significant improvement was seen in domains of role functioning, social functioning, fatigue, pain and global health status, swallowing, dryness of mouth, and feeling ill. The mean CTC count at baseline was 0.90 ± 1.1 / 1.5 ml of blood. Responders showed a decline in levels from 1.19 ± 0.25 to 0.33 ± 0.48, while non-responders had an increasing trend: 0.29 ± 0.48 to 1 ± 0.10 at 3 months (p = 0.010); with concordance rates with response being 52.9%. Additionally, CTC clearance at 3 months had a numerically better PFS of ~6 months (95% CI: 4.72-7.72) and OS of 10 months (95% CI: 2.3-5.65) vs 4 months (95% CI: 2.3-5.65), p = 0.258, and 8 months (95% CI: 4.3-11.6), p = 0.203 in those with persistence of CTCs. Conclusions The triplet regimen of EMF is a feasible, safe therapeutic option with favorable response rates and improved QOL in patients with platinum-resistant/refractory HNSCC. CTCs have a promising futuristic role as a predictive biomarker and can be extrapolated in the clinical upfront setting too. Clinical Trial Information CTRI/2020/02/023378. Know more Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Actorius Innovations AACR 2026 Publications Publications | March 17, 2026 AACR 2026: Depletion of circulating tumor cells using an automated device using non-hemolytic affinity-based substrates Actorius Innovations presents accepted research abstracts at the AACR Annual Meeting 2026, highlighting advances in cancer diagnostics, therapeutics and liquid biopsy. Abstract Background While 90% of cancer deaths are associated with metastasis, it is imperative to monitor early-stage cancer patients for the presence of systemic disease to improve overall survival (OS) and progression-free survival (PFS). Despite complete remission, up to 25–50% of colorectal cancer (CRC) stage II–III and early breast cancer cases are known to relapse. Furthermore, the existence of microtumors often remains undetected by radio-imaging tools due to their limited detection thresholds. Following curative-intent therapies, minimal residual cellular disease (MRCD) may persist and is often represented by circulating tumour cells (CTCs). These cells are known for their ability to extravasate and invade distant sites from the primary tumor. They can also evade immune surveillance. Therefore, there is a need to design safer extracorporeal devices for the capture and depletion of CTCs, particularly those overexpressing PD-L1. In this study, we designed an automated device to capture and remove CTCs from whole blood. Methods We developed an automated microprocessor-operated fluidic device, OncoMetastat, equipped with cartridges for blood and reagent tubes, along with a 3D-printed biocompatible spiral channel. The controller unit powers peristaltic pumps that circulate blood through the spiral channel (96 mm diameter × 6 mm height). The system incorporates 2 mm glass beads conjugated with antibodies and transferrin. Additionally, four vibrators provide micro-stirring to enhance CTC capture from 5–10 mL of patient blood samples (n = 54). White blood cell (WBC) count, hemolysis, and protein binding were measured. The beads were scanned for CTCs using markers CK18⁺, DAPI⁺, and CD45⁻ through an automated imaging system and compared with the OncoDiscover CTC enumeration platform approved by CDSCO India. We analyzed true positives, false negatives, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. Results Retrospectively, blood samples from 54 pan-cancer patients—including breast, colorectal, prostate, and lung cancer—were analyzed to capture and deplete CTCs. The OncoMetastat platform demonstrated a capture efficiency of over 90% when compared with the OncoDiscover platform. Automated scanning achieved 100% efficiency in CTC imaging compared with manual imaging. Leukocyte adhesion was low with anti-EpCAM and transferrin-coated glass beads (2 ± 1 WBCs per sample, n = 54). WBC counts showed cancer-type-specific trends (mean WBC count/mL: 4.9 × 10⁶ for breast cancer, 3.9 × 10⁶ for rectal cancer, and 3.5 × 10⁶ for prostate cancer), representing a 40% decrease compared with healthy controls (mean 6.9 × 10⁶ WBCs/mL). Clinically insignificant hemolysis (<1%) and minimal protein binding (~1.5%) were observed. Vibration-assisted operation enhanced CTC sequestration, achieving more than 90% cell capture efficiency. The platform demonstrated sensitivity of 94.4%, specificity of 92.9%, PPV of 94.4%, NPV of 92.9%, and overall accuracy of 93.8% for CTC capture. Conclusion This study demonstrates efficient and specific depletion of CTCs using the automated device. The platform shows potential as an extracorporeal system capable of removing CTCs from whole blood, thereby offering a promising strategy to enhance cancer therapy outcomes. View Publication Stay One Step Ahead of Cancer. Get the latest news and innovations from Actorius delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe