- Country: 臺灣TAIWAN
- Official Title: 副教授
- Department: 臺北醫學大學 小兒學科
Speech Title
Functional Precision Medi-cine in Pediatric Oncology 小兒腫瘤的功能性精準醫療
Recent advances of genomic medicine have incorporated molecular risk stratification and molecularly targeted therapy into the management of pediatric cancer. A Functional Precision Medicine approach of exposing living patient tumor cells to therapies with signals measured to predict clinical response may further enhance the successful rate of drug selection before treatment. Recently, we enrolled pediatric glioma patients aged 0–21 years for evaluation of drug sensitivity of organoids formed by ex vivo expansion of circulating tumor cells (CTC). The results were correlated with clinical outcomes. Peripheral blood mononuclear cells were obtained from venous blood and processed in a 3D cell culture system (EVA Select™, Cancer Free Biotech Ltd., Taipei, Taiwan) and cultured for 4 weeks. Expanded CTCs were successfully cultured into organoids from 34 cultures from 31 patients and were analyzed for ATP abundance. Staining with CD45, a marker for blood cells, and pancytokeratin, a marker for keratinocytes, was performed on the cultured cells. Staining of GFAP, a marker of glioma cells, was performed in a subset of samples. These cells were then tested in cytotoxicity assays in triplicate with a panel of chemotherapeutic and targeted agents at clinically relevant concentrations. The surviving fraction (SF) was normalized to a buffer-only control and compared with treatment response. Comparing the results among low-grade glioma (LGG; n = 9), high-grade glioma (HGG, n = 12; including glioblastoma multiforme [GBM; n = 5]) and diffuse midline glioma (DMG; n = 13), the mean SF to temozolomide was similarly high across the three tumor types (LGG vs. DMG vs. HGG = 57.5% vs. 50.6% vs. 49.5%, respectively). 6/6 patients in the LGG group showed CTC sensitivity to at least one chemotherapeutic agent tested.