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Circulating tumor cells (CTCs) are promising yet hindered by scarcity. This prospective study validated a simple ex vivo culture protocol after negative selection and assessed correlations between clinical response and CTC growth status. Isolated cells were cultured in 2D with cytokines for up to 21 days, then analyzed by immunofluorescence. Among 37 participants, CTCs were detected and growth rate differences distinguished progressive disease (PD) from non-PD.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/an-ex-vivo-cultivation-model-for-circulating-tumor-cells-the-success-rate-and-correlations-with-cancer-response-to-therapy/331723/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/an-ex-vivo-cultivation-model-for-circulating-tumor-cells-the-success-rate-and-correlations-with-cancer-response-to-therapy/331723.png","ImageObject",300,407,{"name":92,"@type":93},"Valentina","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why are circulating tumor cells (CTCs) considered useful in cancer prognosis?","Question",{"text":112,"@type":113},"CTCs are malignant cells that enter circulation from the primary tumor and can reflect prognostic information for certain cancer types. Their use supports more promising prediction of cancer outcome compared with purely invasive approaches.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What was the key experimental approach in the prospective study?",{"text":117,"@type":113},"After negative selection, isolated cells were cultivated ex vivo in a 2D environment supplemented with cytokines for up to 21 days, followed by immunofluorescence staining for analysis.",{"name":119,"@type":110,"acceptedAnswer":120},"How did CTC growth rate relate to cancer response?",{"text":121,"@type":113},"Patients were categorized into progressive disease (PD) and non-PD groups, and significant differences were observed in CTC growth rates between groups from Days 7–21, supporting the use of growth kinetics to guide observation time and parameters.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},331723,1790167863,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},13056703020460,"https://ap-avatar.wpscdn.com/avatar/be000253dac470eee5d?_k=1778207105932848923","Biomedical Journal 48 (2025) 100819  \nContents lists available at ScienceDirect Biomedical Journal  \njournal [homepage:](homepage: www.elsevier.com/locate/bj)[ www.elsevier.com/locate/bj](homepage: www.elsevier.com/locate/bj)  \n| An Ex vivo cultivation model for circulating tumor cells: The success rate and correlations with cancer response to therapy |  |  | |\n| --- | --- | --- | --- |\n| I-Hsuan Chiang a,b,1, Hsuan-Chih Kuob,c,1, Chun-Ta Liaob,d,1, Yung-Chia Kuob,c,e, Shao-Ming Yu b,c,e, Hung-Ming Wang b,e, Yi-Hui Huang c,e, Kim Anh Nguyen Thib,c,e, Min-Hsien Wu c,e,f, Jason Chia-Hsun Hsieh b,c,e,* \u003Cbr>a Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan b College of Medicine, Chang Gung University, Taoyuan, Taiwan\u003Cbr>c Division of Hematology-Oncology, Department of Internal Medicine, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan d Department of Otorhinolaryngology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan\u003Cbr>e Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan f Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan |  |  |  |\n| A R T I C L E I N F O |  | A B S T R A C T |  |\n| Keywords:\u003Cbr>Circulating tumor cells (CTCs)\u003Cbr>Negative selection Ex vivo culture Clinical response CTC growth rate |  | Background: Cancer mortality is closely linked to recurrence and distant metastasis, posing challenges in realtime tracking due to the invasiveness of current methods. Circulating tumor cells (CTCs) show promise as potential tools; however, their scarcity remains a significant obstacle.\u003Cbr>Method: In this prospective study, we validated a simple culture protocol and investigated the correlation between clinical response and CTC growth status. Following negative selection, the isolated cells were subjected to ex vivo cultivation in a two-dimensional environment supplemented with cytokines for up to 21 days, followed by immunofluorescence staining for analysis.\u003Cbr>Results: Among 37 participants with solid tumors and distant metastasis (34.8% head and neck cancer), 47 samples were collected, from which CTCs were detected. The percentages of CTCs, atypical CTCs, and white blood cells during cultivation from days 7–21 were significantly different (p \u003C 0.001, p \u003C 0.001, and p = 0.330, respectively). Patients were further categorized into progressive disease (PD) and non-PD groups based on disease status, revealing significant differences in CTC growth rates, which increases from Days 7–21 between groups (5.5x vs. 2.8x growth, respectively; p \u003C 0.001).\u003Cbr>Conclusion: With the proposed protocols, we cultured CTCs from patients with various cancers for 21 days and identified a tool for predicting cancer response. The actual cancer status (PD or non-PD) at CTC isolation correlates to CTC growth rate, guiding the required observation time and parameters for culture. |  |\n\n1. Introduction  \nCancer is a leading cause of death worldwide. In 2024, 2,001,140 new cancer cases and 611,720 cancer deaths are estimated in the United States [1]. Despite significant advances in cancer research and the development of various treatment modalities, none have been proven to cure cancer in all patients. Moreover, cancer recurrence has been identified as a major contributor to decreased cancer survival rates [2–4]. According to the American Cancer Society, the 5-year survival  \nrate for all cancers was approximately 86%, with a considerable decline in survival rates observed in advanced stages of cancer [5–7]. An improved understanding of tumor biological behaviors may hold the key to predicting cancer recurrence and developing effective treatment strategies to prevent relapse [8].  \nA variety of tools and methods have been developed to predict cancer behavior. Several researchers have attempted to use tumor tissue genetic analysis and multiomics to predict cancer behavior [9]. However, t","cbCaid4XPh2MDv9g","https://ap.wps.com/l/cbCaid4XPh2MDv9g","pdf",7701010,"English","# Introduction\n## Cancer burden and need for prediction\n## Liquid biopsy and CTC rationale\n## Limitations of CTC detection and role of culture","[{\"question\":\"Why are circulating tumor cells (CTCs) considered useful in cancer prognosis?\",\"answer\":\"CTCs are malignant cells that enter circulation from the primary tumor and can reflect prognostic information for certain cancer types. Their use supports more promising prediction of cancer outcome compared with purely invasive approaches.\"},{\"question\":\"What was the key experimental approach in the prospective study?\",\"answer\":\"After negative selection, isolated cells were cultivated ex vivo in a 2D environment supplemented with cytokines for up to 21 days, followed by immunofluorescence staining for analysis.\"},{\"question\":\"How did CTC growth rate relate to cancer response?\",\"answer\":\"Patients were categorized into progressive disease (PD) and non-PD groups, and significant differences were observed in CTC growth rates between groups from Days 7–21, supporting the use of growth kinetics to guide observation time and parameters.\"}]","An Ex vivo cultivation model for circulating tumor cells - The success rate and correlations with cancer response to therapy | PDF",1789994875]