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Publications | 3 November 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 Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Literature | 9 March 2026 OncoMetastat Brochure Detailed Brochure for OncoMetastat Download Brochure Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Press Release | 5 February 2026 Actorius and ACTREC Partner to Advance Clinical Cancer Research. A collaborative research initiative to study the practical utility of Circulating Tumor Cells and their capture and depletion from patient's blood as possible aid to adjunct therapeutics. Big step forward for Actorius Innovations and Research 🙌 Actorius recently signed an MOU with Advanced Centre for Treatment, Research and Education in Cancer(ACTREC) to collaborate on clinical studies and research spanning - practical utility of Circulating Tumor Cells and their capture and depletion from patient’s blood as possible aid to adjunct therapeutics. Slowing down or blocking metastasis cascade in early stage patients. Extremely bold and breakthrough innovation hypothesis. This partnership is about taking science closer to patients—generating meaningful real-world evidence, strengthening translational research, and asking the right clinical questions where it truly matters. The MOU was signed by Dr. Pankaj Chaturvedi , Director, ACTREC, and Dr. Jayant Khandare , Co-Founder & CSO, Actorius Innovations and Research. Excited about what lies ahead and the impact this collaboration can create together. Aravindan Vasudevan Rick Kamble Know more Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Publications | 3 June 2025 Circulating tumor cells and clusters exhibiting expression of PD-L1 in colorectal patients. High prevalence of PD-L1–positive circulating tumor cells in colorectal cancer highlights their role in minimal residual disease and recurrence monitoring. Background The role of circulating tumor cells (CTCs) has been well established in predicting survival in metastatic settings, particularly in breast, colorectal, and prostate cancers. However, their clinical utility has been limited due to high costs, variability in sensitivity and accuracy, and the use of cutoff-based interpretations. The biological significance of CTCs—from extravasation and invasion to their contribution to tumor microenvironment dynamics and tumor burden—suggests greater clinical relevance than is currently applied in practice. Their role in monitoring minimal cellular residual disease (MCRD), especially in early-stage cancers post-surgery, remains underexplored, including decisions regarding therapy duration in diseases such as colorectal cancer and longitudinal monitoring for recurrence. Dynamic PD-L1 expression on CTCs may indicate incomplete tumor resection or treatment response and may also reflect cellular dormancy in circulation, potentially enabling immune evasion. In this study, we report the expression of PD-L1 on CTCs and CTC clusters in colorectal cancer patients. Methods We retrospectively analyzed 666 colorectal cancer patients (63.06% male and 36.94% female), spanning early- to late-stage disease, for the presence of CTCs with and without PD-L1 expression, as well as CTC clusters. CTCs were detected using the CDSCO-approved OncoDiscover platform in 1.5 mL of peripheral blood. Cells were classified as CTCs if they were EpCAM⁺, CK18⁺, DAPI⁺, and CD45⁻, and were identified using an automated Zeiss microscope system. Results At baseline analysis, 74.25% (n = 591) of patients had ≥1 CTC per 1.5 mL of blood. CTC counts ranged from 1 to 20 cells. Among patients with detectable CTCs, 74.62% (n = 441) exhibited PD-L1 expression. The highest proportion of CTCs (~25.86%, n = 352) was observed in the 61–70 years age group. CTC clusters were detected in 13.00% (n = 156) of patients, and notably, more clusters were observed during follow-up compared with baseline. The mean CTC count (including clusters) was 1.71, while the mean PD-L1–positive CTC count was 1.02. Conclusions PD-L1 expression on CTCs may contribute to their ability to persist in circulation through immune evasion, potentially enabling dormancy via surface protein overexpression that helps them avoid elimination by immune T cells. The CTC–PD-L1 assay shows strong potential for patient surveillance both before and after treatment in assessing minimal cellular residual disease. Further clinical studies in this direction are strongly warranted. View Publication Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Publications | 15 January 2023 AACR 2023: Abstract PR007: Comprehensive ctDNA profiling reveals potential metastatic genomic signatures in treatment-naive early-stage breast cancer patients Comprehensive ctDNA profiling and CTC analysis in early-stage breast cancer identifies driver mutations to predict early metastasis. Background Genomic profiling has revolutionized precision oncology, impacting diagnosis, prognosis, and therapy decisions. Considering the high spatiotemporal diversity and heterogeneity of breast tumor-cell genomes, small-gene panels often fail to capture rare but important genomic alterations. Conversely, comprehensive ctDNA sequencing approaches enable the identification of under-characterized 'long-tailed driver' genomic alterations and capture intra- and inter-metastatic heterogeneity. Here, we demonstrate the clinical utility of comprehensive genome profiling with higher sensitivity to predict the possibility of metastasis in early-stage breast cancer patients. Methods We retrospectively analyzed ctDNA and genomic DNA (gDNA) from FFPE samples, as well as circulating tumor cells (CTCs), in 10 treatment-naive, hormone-positive, and HER2-negative primary-stage breast cancer patients using the OncoIndx comprehensive 600-gene panel. The panel captures all important cancer-relevant genomic alterations, including tumor mutation burden (TMB), microsatellite instability (MSI), homologous recombination deficiency (HRD) prediction, and cfDNA tumor fraction (TF). CTCs were enumerated from 1.5 ml of blood using the OncoDiscover platform, approved by the Drug Controller General of India, using anti-EpCAM antibody-mediated immunomagnetic nanoparticles. CTCs were confirmed for cytokeratin 18+ and DAPI+ markers, and the absence of CD45. Results The comprehensive genomic profile obtained from ctDNA and gDNA from the FFPE of early-stage breast cancer patients predominantly exhibited the presence of alterations in PIK3CA and ESR1 signaling pathways. PIK3CA mutations were present in 77% and 44% of baseline ctDNA and gDNA samples, while ESR1 mutations were present in 44% and 22% of baseline ctDNA and gDNA, respectively. In addition, we observed about 70% additional driver mutations in ctDNA samples, suggesting the shedding of ctDNA together with CTCs (80% positive) as a likely positive biomarker of metastasis. About 50% of the patients showed higher TMB and HRD. Notably, TF representing ctDNA varied between 13% to 27% in blood samples with a corresponding ploidy range of 2.9 to 4.7. Surprisingly, ~50% of the patient population matched the mutation profile of clinically confirmed metastatic patients. All the patients harboring potential metastatic driver alterations showed the presence of CTCs in peripheral blood. Conclusions Comprehensive ctDNA genomic profiling showed potential metastasis-driving alterations, suggesting the role of ctDNA-based liquid biopsy to predict metastasis in early breast cancer patients. We observed enhanced TF at the time of diagnosis, possibly due to the presence of distant metastasis, high disease burden, and aggressive tumor biology. Our results suggest that ctDNA dynamics at the time of disease presentation can predict early metastasis and may demonstrate the divergent response of tumor heterogeneity to treatment in early-stage breast cancer. Know more Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Publications | 7 March 2026 AACR 2020: Clinical correlation of circulating tumor cells as a blood marker in Indian head and neck cancer patients. A study of 350 Indian HNC patients confirms CTCs correlate with nodal stage and aggressive features, validating their use as a clinical staging marker. Objectives To establish a rapid, highly specific, efficient, sensitive, and affordable CTC enumeration liquid biopsy technology and to validate its efficacy to isolate CTCs disseminating from epithelial tumors of the HNC subpopulation in India. Furthermore, the study aimed to investigate the correlation of CTC distribution from peripheral blood with respect to various clinicopathologic factors in these patients. Materials and Methods A cross-sectional study was conducted using peripheral blood from 350 enrolled HNC patients. CTCs were isolated using DCGI (India) approved technology that exploits EpCAM-based immunomagnetic separation. EpCAM+ tumor cells were isolated from only 1.5 ml of blood and critically assayed for cytokeratin 18 (CK18) expression. These cells were quantified using fluorescence imaging to obtain a threshold to further minimize nonspecific and false-positive enumeration. CTC enumeration was subsequently subjected to statistical correlation with various clinical and pathologic parameters. Results CTCs were detected in all HNC patients across various subsites. There was a minimum threshold of at least 12 CTCs in early oral cancer patients according to their clinicopathologic signatures. Compared to early oral cancer patients, advanced nodal patients showed a 40% escalation in CTC count, while an increase of up to 80% was observed when associated with aggressive features such as lymphovascular emboli (LVE) and extranodal extensions. Notably, laryngopharyngeal primary cases had the highest mean CTC count of 33 in 1.5 ml of blood. Conversely, patients with advanced disease had higher CTC counts, and this was staggered in comparison with nearly—but not all—clinical features. Remarkably, a higher clinical N (nodal) stage statistically correlated with increased CTC counts. A marked increase in CTCs was also seen in tumors that showed lymphovascular emboli on histopathology and extranodal extension. The CTC counts were independent of parameters such as age, sex, T stage, perineural invasion, bone involvement, or skin involvement. There was a notable trend toward reduced CTC counts after chemotherapy; however, it was not statistically significant. Conclusion This rapid and efficient CTC platform has been clinically validated for use in Indian HNC phenotypes. This is the first comprehensive study to show a staggering positive correlation between CTCs and various clinicopathologic factors, encompassing the largest number of oral cancer patients across the entire spectrum of HNSCC—the most common cancer in India. High CTC counts among HNC patients could possibly be one of the reasons for dismal outcomes, and further studies correlating CTCs with patient survival in HNC are warranted. However, this study strongly implicates the prospective utility of CTCs as a tumor marker in establishing clinical staging for HNC patients. Know more Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Press Release | 11 April 2024 Magnetic nanocrystals capture tumour cells from blood samples These nanomaterials could speed up discovery of anti-cancer drugs Cellulose-based magnetic nanocrystals and nanofibres can capture circulating tumour cells (CTCs) from the blood samples of head and neck cancer patients. A magnet is used to separate the trapped tumour cells, which are then identified under a fluorescence microscope. This technique could potentially be used to monitor cancer progression in real time, says an international team, which included researchers at North Dakota State University, USA, the Tata Memorial Hospital in Mumbai, and Actorius Innovations and Research, and Dr. Vishwanath Karad MIT World Peace University, both in Pune. Click the below link to read the full article. Know more Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Publications | 6 June 2023 ASCO 2023: Effect of circulating tumor cells distribution in treatment naive and treated patients with advance stage breast cancer on disease burden. A study of 417 breast cancer patients shows tracking circulating tumor cells (CTCs) effectively monitors therapy response and recurrence risk. Background Breast malignancies are a leading cause of cancer-related mortalities and show an ascending incidence rate. Despite advancements in our understanding of the disease, its clinical outcome is often dismal. This largely remains owing to the characteristic wide window of relapse, spanning months to decades after primary treatment. Therefore, continuous monitoring of the disease is an offered choice to detect metastatic progression and recurrence. Circulating tumor cells (CTCs) have emerged as a powerful prognostic tool to predict the disease outcome in many epithelial cancers. CTCs are a real-time surrogate biomarker accounting for minimal residual disease (MRD) which is often missed in CT PET scanning. This leads to a progression of metastasis when the patient is often considered as 'clinically disease free'. Here, we analyzed the presence of CTCs in treatment-naive and chemo-recipient breast cancer patients. Methods In this retrospective study on 417 breast cancer patients, CTCs were isolated from 1.5 ml of blood using the Drug Controller General of India (DCGI) 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 based on an automated digital imaging platform. Results 42.6% (n=178) of patients were clinically at a progressive stage (stage II and III) and treatment-naive. On the other hand, 47.4% of patients received treatment including surgery and chemotherapy. CTCs were not observed in 5.6% (n=10) of the treatment-naive population, while 32% (n=75) of patients who received therapy did not show CTCs. The mean CTC number in treatment-naive patients was 15, while the mean CTC count in patients receiving therapy was drastically reduced to 2. This implied that therapy effectively countered the tumor progression and reduced the shedding of tumor cells in circulation. The distribution of CTC in treatment-naive patients exhibited a bimodal trend centered at values of 10 and 50, suggesting two distinct populations of patients with respect to CTC count. CTC count did not show any correlation with the age in both population groups. Surprisingly, CTC count in younger patients (20-50 years) was 50% higher compared to the older population (50-75 years). Conclusions The presence of CTCs in treatment-naive, progressive breast cancer patients indicated biologically aggravated disease. Although therapeutic intervention drastically reduced the CTC burden, their presence in a large population was suggestive of an MRD and the likelihood of recurrence after discontinuation of therapy. A distinct pattern of CTC occurrences in Tx naive and Tx recipient patients suggested that CTCs can be an important clinical indicator to monitor the therapy response, progression, and residual disease. Know more Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Publications | 30 August 2026 Capture of Epithelial-Mesenchymal Transitioning Circulating Tumor Cells using Affinity Based N-Cadherin System A study demonstrating N-Cadherin affinity-based capture of EMT-associated CTCs in diverse cancers, with Vimentin-positive CTC detection in 90% of samples and N-Cadherin expression revealing heterogeneous metastatic phenotypes. Introduction: Epithelial-to-mesenchymal transition (EMT) enables tumour cells to lose epithelial characteristics, acquire enhanced motility and aggressive invasiveness, and activate metastatic dissemination. Circulating tumour cells (CTCs) undergoing true EMT possess greater metastatic potential than purely epithelial CTCs because they exhibit increased survival in the bloodstream, immune evasion, and the ability to colonise distant organs. Thus, detection and characterization of EMT-CTCs provide clinically valuable insights into metastatic risk, disease progression, and treatment resistance beyond conventional epithelial CTC enumeration. Here, we report an N-Cadherin affinity-based ligand CTC-capture platform for capturing CTCs demonstrating varied EMT-CTC phenotypes. Methods: Retrospectively, we analyzed blood samples from 30 cancer patients, including colorectal cancer stages I–IV (n=9), breast/TNBC (n=7), advanced lung adenocarcinoma (n=2), pancreatic cancer, anaplastic thyroid cancer, endometrial cancer, head and neck cancer, melanoma, and others. The cohort comprised 18 female and 12 male patients aged 19–84 years. We first validated Vimentin-positive MCF-7 cells using the OncoMetastat platform containing N-Cadherin glass beads for cellular localization. CTCs were captured using N-Cadherin glass beads from 1.5 mL of blood and subsequently confirmed based on Vimentin+, DAPI+, N-Cadherin+, and CD45− expression using a Nikon Ti-2 fluorescence microscope. Results: Vimentin-positive CTCs were detected in 27/30 (90%) cancer patient blood samples. A total of 42 CTCs were captured, with a mean distribution of approximately 1.4 CTCs per sample and a range of 1–3 CTCs. Among the isolated CTCs, 13/42 (30.9%) expressed cellular N-Cadherin. Importantly, N-Cadherin expression was observed in 5/10 (50%) colorectal cancer (CRC) samples and 3/7 (42.8%) breast cancer samples. In six patients, intra-CTC heterogeneity was observed, with both N-Cadherin-positive and N-Cadherin-negative CTCs. The MCF-7 cell study demonstrated >90% cell capture using the N-Cadherin affinity platform, with Vimentin localization. Conclusion: We demonstrate the capture of true epithelial-to-mesenchymal transitioning CTCs using an affinity-based N-Cadherin system in cancer patients. Further studies are required to investigate comparative CTC detection using anti-EpCAM antibodies and N-Cadherin, as well as their association with clinical outcomes. Know more Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Publications | 30 August 2026 Comparative Analysis of Circulating Tumor Cells, Clusters, and PD-L1 Expression in Paired Peripheral and Portal Venous Blood with Solid Malignancies A prospective study compares circulating tumor cells, CTC clusters, and PD-L1 expression in paired peripheral and portal venous blood, highlighting compartment-specific differences and the potential of dual-compartment liquid biopsy profiling. Introduction Circulating tumor cells (CTCs) are an established biomarker for prognostication, minimal residual cellular disease (MRCD), and treatment monitoring. Portal venous blood (PVB), which directly drains gastrointestinal and hepatobiliary tumors, may contain a higher CTC population than peripheral blood (PB) and could serve as a strong predictive biomarker for postoperative relapse in resected pancreatic cancer. This study evaluates CTC enumeration, CTC clusters, and PD-L1 expression in paired PB and PVB samples. Methods In this prospective observational study, paired PB and PVB samples were collected from 12 patients with hepatobiliary, pancreatic, colorectal, and gastric malignancies during interventional procedures. CTCs were enriched and identified using validated morphological and immunophenotypic criteria. PD-L1 expression and CTC clusters were evaluated by immunostaining. Detection rates, mean CTC counts, compartment concordance, and cancer-specific differences were analyzed descriptively. Results Eleven paired samples were evaluable. CTC positivity was observed in 90.9% (10/11) of PB samples and 81.8% (9/11) of PVB samples. Mean CTC counts were identical in both compartments (1.09). PD-L1-positive CTCs were more frequently detected in PB than PVB (45.5% vs. 18.2%), with corresponding mean counts of 0.45 and 0.18, respectively. CTC clusters were identified in 18.2% of cases in both compartments. Hepatocellular carcinoma and cholangiocarcinoma demonstrated high PB-PVB concordance, whereas pancreatic and rectal cancers showed compartment-specific discordance. Single CTCs predominated in both PB (72.7%) and PVB (63.6%). Conclusion Portal venous sampling is feasible and provides CTC detection rates comparable to peripheral blood. However, PB demonstrated greater detection of PD-L1-positive CTCs, suggesting compartment-specific biological differences. Combined assessment of PB and PVB may enhance liquid biopsy characterization, particularly in gastrointestinal malignancies. Larger prospective studies are warranted to define the clinical value of dual-compartment CTC profiling. Know more Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Publications | 3 June 2024 ASCO 2024: Impact of ctDNA genomic mutations and CTCs biomarker duo on clinical concordance in localized, progressive, and metastatic disease. Dual biomarker analysis of ctDNA and circulating tumor cells reveals disease progression and metastasis across multiple cancer types. Background Genomic mutations identified from circulating tumor DNA (ctDNA) have been shown to correlate positively with clinical disease status. EGFR and intracellular cell progression and proliferation pathways involving BRCA1/2 and TP53 genes drive high ctDNA load in progressive cancer patients. Circulating tumor cells (CTCs) indicate cellular residual disease (CRD). Together, ctDNA and CTCs as dual biomarkers offer predictive insights into tumor progression and metastasis, which may be valuable for early detection and treatment modifications. Methods In a retrospective study, 96 cancer patients (including lung, colorectal, breast, stomach, and other cancers) who had recently undergone treatment were investigated for the presence of CTCs and genomic mutations from ctDNA using the OncoMonitor test. Libraries were prepared using a hybridization-capture method covering 1000 targets with a mean sequencing depth of 5000× on the Illumina NextSeq 2000 platform. The test detected genomic alterations including single nucleotide variations (SNVs), small insertions and deletions (INDELs), copy number variations (CNVs), and translocations (fusions) using a 96-gene panel. CTCs were isolated using the OncoDiscover platform and identified as CK18+, PD-L1+, CD45- cells in 1.5 ml of blood. Results Among the 96 pan-cancer patients, 15.6% (n = 15) were identified with localized progressive disease without metastasis based on radiological findings, of which 60% (n = 9) showed at least one genomic alteration detected from ctDNA. Additionally, 12.5% (n = 12) patients were identified with metastatic disease from radiological findings, of which 58.3% (n = 7) showed the presence of at least one CTC. Among these, 33.3% (n = 4) patients had two CTCs, while five patients had no detectable CTCs. Furthermore, metastatic patients showed ctDNA load in 66.6% (n = 8) of cases with at least one genomic finding. In the metastatic disease cohort, CTC enumeration showed a concordance of 58.3% (n = 7) with metastatic radiological findings, while genomic findings from ctDNA showed a concordance of 66.6% (n = 8) with metastatic radiological findings. Among 23.9% (n = 23) patients identified radiologically with stable or treatment-responsive disease, 73.9% (n = 17) had no detectable genomic mutations from ctDNA, and 26.0% (n = 6) were CTC-negative, consistent with radiological findings. However, 26.0% (n = 6) patients had at least one genomic finding, contributing to discordance with radiological findings. Overall, genomic findings from the dual biomarkers showed concordance with radiological findings in 26.6% (n = 4) patients with progressive disease, 41.6% (n = 5) patients with metastatic disease, and 17.3% (n = 4) patients with stable or treatment-responsive disease. Conclusions Patients with progressive and metastatic disease identified through radiological findings showed concordance with dual ctDNA and CTC biomarkers. The concordance of ctDNA in progressive disease and CTC detection in metastatic disease highlights the individual significance of these biomarkers and supports their combined use for monitoring disease status and guiding treatment decisions. Know more Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe

Publications | 3 June 2025 Quadrant of co-occurrence of circulating tumor DNA and PD-L1 expression on circulating tumor cells in monitoring disease aggressiveness and metastasis in lung cancer. Combined ctDNA and PD-L1–positive CTC analysis improves monitoring of metastasis, minimal residual disease, and treatment response in lung cancer. Background Liquid biopsies analyzing circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) enable minimally invasive monitoring and testing of lung cancer across different stages. Approximately 90% of patients succumb due to metastasis. However, identifying patients with early metastatic signatures remains extremely challenging. In addition, monitoring minimal residual disease (MRD) and identifying patients at risk of recurrence is highly important. While the prognostic role of CTCs in predicting survival has been established in several cancers, the combined role of CTCs and ctDNA in monitoring disease aggressiveness, treatment response, and therapeutic decision-making has not been extensively explored. In this study, we investigated the combined roles of ctDNA and CTCs in monitoring disease aggressiveness and metastasis in lung cancer patients. Methods A cohort of 265 late-stage lung cancer patients was retrospectively analyzed for the co-occurrence of the dual biomarkers ctDNA and CTCs. The results were correlated in a quadrant-based model to assess clinical disease states derived from PET scans and histopathological examination (HPE) findings. Next-generation sequencing (NGS) was performed using the OncoMonitor dual biomarker assay, which includes CTC enumeration with PD-L1 expression analysis. CTC counts were determined using the OncoDiscover Liquid Biopsy Test, approved by CDSCO-India, from 1.5 mL of blood. Results CTC distribution ranged from 1 to 8 cells, with a mean value of 1.22. Among the patients, 75.47% (n = 200) were CTC-positive, and among these, 91.50% (n = 183) exhibited PD-L1 expression on their CTCs, with a mean PD-L1–positive CTC value of 0.99. Both biomarkers were positive (ctDNA⁺/CTC⁺) in 135 patients (50.94%). Only 19 patients (7.17%) were negative for both biomarkers (ctDNA⁻/CTC⁻). Additionally, 43 patients (16.23%) were ctDNA⁺/CTC⁻, while 68 patients (25.66%) were ctDNA⁻/CTC⁺. The ctDNA⁺/CTC⁻ cohort exhibited the highest metastatic rate at 62.8%, followed by the ctDNA⁺/CTC⁺ group at 57.0%. The ctDNA-positive cohort showed the highest proportion of progressive disease (20.2% and 18.6% in CTC⁺ and CTC⁻ subgroups, respectively). Mutations in EGFR, TP53, and KRAS were observed in 62.64% (166/265) of patients. Stable disease was observed in 29.4% of patients when both biomarkers were absent (ctDNA⁻/CTC⁻). Conclusions Overall, the ctDNA-positive cohort demonstrated higher rates of MRD, disease progression, and metastasis, with no cases of stable disease. The combined quadrant analysis of CTC-PD-L1 cells and ctDNA provides a non-invasive approach for monitoring disease progression, treatment response, complete remission, and early metastatic detection in lung cancer patients. View Publication Never Miss a Breakthrough. Get the latest news and innovations from OncoMetastat delivered straight to your inbox. Subscribe for regular updates Email* Yes, subscribe me for regular updates. * Subscribe