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Publications | 30 August 2026 Evaluation of circulating tumor cells expressing PD-L1 and CTC clusters at baseline and follow ups in triple-negative breast cancer A retrospective study of 180 TNBC blood samples evaluated CTC burden, PD-L1 expression and CTC clusters using the CDSCO-approved OncoDiscover platform, highlighting their potential for longitudinal disease monitoring and biomarker-guided management. Introduction: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype characterized by a high risk of recurrence and metastasis. Assessment of circulating tumor cells (CTCs), along with evaluation of PD-L1 expression and CTC clusters, provides prognostic, minimal cellular residual disease (MCRD), and predictive information. The duration of longitudinal CTC monitoring has not been established. This study evaluates the implications of detecting CTC burden, PD-L1 expression, and CTC clusters in TNBC patients at baseline and during follow-up for improved clinical outcomes. Methods: This retrospective observational study analyzed 180 peripheral blood samples from patients with TNBC, including 141 baseline (BL) and 39 longitudinal follow-up (FU) samples. Peripheral whole blood (1.5 mL) was processed using the CDSCO-approved OncoDiscover liquid biopsy platform, which employs antibody-mediated immunomagnetic enrichment and automated fluorescence microscopy to identify EpCAM⁺/CK18⁺/DAPI⁺/CD45⁻ CTCs. CTC positivity was defined as ≥1 confirmed CTC. Descriptive statistics were used to evaluate CTC burden, PD-L1-positive CTCs, and CTC clusters across BL and FU cohorts and age groups. Results: CTCs were detected in 114/180 (63.3%) patients, while 66 (36.7%) were CTC-negative. PD-L1-positive CTCs were identified in 62/114 (54.4%) CTC-positive patients (34.4% of the overall cohort), and CTC clusters were detected in 17/180 (9.4%) patients. The overall mean CTC count was 0.91, with higher values observed in FU than BL samples (1.18 vs. 0.81). Mean CTC cluster counts were also marginally higher in FU samples (0.10 vs. 0.09). Most CTC-positive patients harbored a single CTC (77/180, 42.8%), followed by two (14.4%), three (5.0%), and four (1.1%) CTCs. Patients aged 20–30 years demonstrated the highest mean CTC count (1.83), whereas those aged 71–80 years had the lowest mean CTC count (0.50). Conclusion: The OncoDiscover platform detected CTCs in nearly two-thirds of patients with TNBC and demonstrated that more than half of CTC-positive patients expressed PD-L1. Simultaneous assessment of CTC enumeration, PD-L1 expression, and CTC clusters represents a promising minimally invasive strategy for longitudinal disease monitoring and biomarker-guided management in TNBC. Monitoring changes in CTCs and the duration of longitudinal MCRD from baseline remains critical, although this is not yet well established. 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

Manuscript | 4 April 2024 Manuscript: CTC together with Shh and Nrf2 are prospective diagnostic markers for HNSCC Study links Shh/Nrf2 overexpression with circulating tumor cells in HNSCC, highlighting their potential as biomarkers for early detection and survival prediction. Background The lack of appropriate prognostic biomarkers remains a significant obstacle in the early detection of Head and Neck Squamous Cell Carcinoma (HNSCC), a cancer type with a high mortality rate. Despite considerable advancements in treatment, the success in diagnosing HNSCC at an early stage still needs to be improved. Nuclear factor erythroid 2-related factor 2 (Nrf2) and Sonic Hedgehog (Shh) are overexpressed in various cancers, including HNSCC, and have recently been proposed as possible therapeutic targets for HNSCC. Circulating Tumor Cell (CTC) is a novel concept used for the early detection of cancers, and studies have suggested that a higher CTC count is associated with the aggressiveness of HNSCC and poor survival rates. Therefore, we aimed to establish molecular markers for the early diagnosis of HNSCC considering Shh/Nrf2 overexpression in the background. In addition, the relation between Shh/Nrf2 and CTCs is still unexplored in HNSCC patients. Methods In the present study, we selected a cohort of 151 HNSCC patients and categorized them as CTC positive or negative based on the presence or absence of CTCs in their peripheral blood. Data on demographic and clinicopathological features with the survival of the patients were analyzed to select the patient cohort to study Shh/Nrf2 expression. Shh and Nrf2 expression was measured by qRT-PCR. Results Considering significant demographic [smoking, betel leaf (p-value < 0.0001)] and clinicopathological risk factors [RBC count (p < 0.05), Platelet count (p < 0.05), Neutrophil count (p < 0.005), MCV (p < 0.0001), NLR (p < 0.05), MLR (p < 0.05)], patients who tested positive for CTC also exhibited significant overexpression of Shh/Nrf2 in both blood and tissue compared to CTC-negative patients. A strong association exists between CTCs and tumor grade. Following chemotherapy (a combination of Cisplatin, 5FU, and Paclitaxel), the frequency of CTCs was significantly decreased in patients with HNSCC who had tested positive for CTCs. The Kaplan–Meier plot illustrated that a higher number of CTCs is associated with poorer overall survival (OS) in patients with HNSCC. View Manuscript 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 | 17 March 2026 Actorius Innovations pioneers' oncology care with its OncoDiscover and OncoMetastat solutions Dr. Jayant Khandare Leads Actorius with Pathbreaking Innovations in Cancer Detection and Metastasis Control Actorius Innovations and Research Pvt Ltd, a pioneering Indo-US biotechnology company revolutionizing oncology through advanced circulating tumor cell (CTC) technologies, continues to make significant strides under the visionary leadership of Dr. Jayant Khandare, Founder, Managing Director, and Chief Scientific Officer. Click the button below to read the full story 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 | 17 March 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 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 | 17 March 2026 ASCO 26: Assessment of circulating tumor cells and clusters expressing PD-L1 in urological cancers High prevalence of PD-L1–positive circulating tumor cells in urological cancers, especially prostate cancer, indicating minimal residual disease and recurrence risk. Abstract Background Urological cancers, including prostate, bladder, kidney, testicular, and penile cancers, often fail to show symptoms or show only nonspecific symptoms at early stages. This leads to delayed diagnosis, treatment decisions, and outcomes. Circulating tumor cells (CTCs) predict the outcome in metastatic prostate cancer (PC). Furthermore, in bladder cancer, CTC positivity is linked to muscle invasion, higher recurrence risk, and worse clinical outcomes. CTC PD-L1 expression could evade immune elimination. In spite of complete remission, a higher percentage of patients are known to recur in urothelial cancers. CTCs acting as minimal cellular residual disease (MCRD) are highly implicated, knowing their capacity to be dormant systemically with extravasation and invasion to distant organs. We analyzed the presence of CTCs with PD-L1 over-expression in urological cancers at baseline and follow-ups. Methods Retrospectively, a total of 359 urological cancer patients were evaluated for CTC positivity, including 307 at baseline and 52 follow-up samples. The cancer type distribution was prostate cancer (n = 139), bladder (n = 188), kidney (n = 10), testes (n = 2), penis (n = 8), urothelial (n = 12), etc. Ninety-five percent of the patients were male (n = 293) and 5% were female (n = 14), with most patients aged 61 to 80 years. CTCs expressing PD-L1, positive CTCs, and CTC clusters were analyzed using OncoDiscover® PD-L1 markers and a Zeiss fluorescence automated microscope. Demographics, cancer mean distribution, and CTC and cluster frequency were analyzed. Results Of the 359 patients, CTCs were detected in 68.2% (245/359) of patients, while PD-L1 over-expression on CTCs was present in 49.9% (179/359) of patients. However, CTC clusters were uncommon and occurred in 7.2% (26/359) of patients. Across cancer types (total CTCs = 436), prostate cancer accounted for higher CTCs with a mean CTC distribution of 2.18, while bladder was 0.74, urothelial 0.34, testes 0.18, kidney 0.74, and penis 0.38, respectively. CTC PD-L1 was highest in prostate cancer (46.1%) compared to other cancers, and CTC cluster prevalence was 1.8% in prostate cancer, urothelial (0.9%), and bladder (0.2%) cancers. In CTC-positive cases, 56.3% of patients had only one CTC, 27.8% showed two CTCs, and 8.2% had three. The mean across all patients was 0.6 for CTCs, 0.3 for CTC-PD-L1 positive, and 0.1 for clusters. Conclusions CTCs with PD-L1-positive overexpression were observed across urological cancers, being particularly higher in prostate cancer compared to bladder, kidney, and penis cancers. Many patients are known to recur in spite of complete remission, possibly due to the presence of aggressive CTCs in circulation that could evade the immune system. More studies assessing the presence of CTCs with PD-L1 expression are justified in urological cancers for minimal cellular residual disease and as prognostication. 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 | 16 September 2025 PD-L1 overexpression on circulating tumor cells and CTC clusters: A potential biomarker across solid carcinomas Correlation of CTC detection, PD-L1 expression, and CTC clusters highlights biomarkers for minimal residual disease and cancer progression monitoring. Abstract Background Overexpression of the dynamic protein PD-L1 on circulating tumor cells (CTCs) is a highly implicative biomarker that represents post–curative intent status, minimal residual disease (MRD), disease aggressiveness, therapeutic response, and metastatic progression. We evaluated the correlation among CTC detection, PD-L1 expression, and CTC clusters present in solid tumors, namely lung, breast, colorectal, ovarian, and prostate carcinomas. Longitudinal monitoring of CTCs remains a major focus after treatments, including surgical intervention with curative intent. Methods Retrospectively, we analyzed 328 cancer patients (male 163, female 165) across stages, consisting of a total of 383 samples with baseline and follow-ups (n = 55). Cancer types included lung (27.13%), colorectal cancer (21.95%), breast (9.75%), ovary (4.2%), prostate (3.9%), and others. CTCs and clusters were detected from 1.5 ml peripheral blood using the OncoDiscover platform approved by the Central Drugs Standard Control Organization of India. The platform contains a multifunctional magneto-nanosystem mediated by anti-epithelial cell adhesion molecule (EpCAM) antibody. CTCs were confirmed as EpCAM+ve, CK18+ve, DAPI+ve, and CD45–ve. PD-L1 expression on CTCs was detected based on the linear intensity gradients of fluorescence signals using image acquisition on an automated fluorescence microscope. Results Among the 383 samples with baseline and follow-ups, 69.45% of patients had CTCs ranging from 1–11. Approximately 77% of patients were above the age of 50. The total number of CTCs observed was ~649 with a mean distribution of ~1.69. CTCs with PD-L1 overexpression were observed in 55.35% of patients (n = 266). Higher CTC prevalence was observed in lung cancer (24.75%), followed by colorectal cancer (21.57%) and breast cancer (5.89%). CTC clusters were observed in 10.18% of patient samples. Notably, concurrent positivity for both CTCs and PD-L1 expression was most prevalent in lung cancer patients, suggesting a potential aggressive disease phenotype and therapeutic vulnerability. Conclusions The findings support the integrated use of CTCs and their PD-L1 expression as a composite biomarker strategy to stratify patients for targeted therapies, immunotherapeutic interventions, and longitudinal monitoring. 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 | 4 June 2019 ASCO 2019: Correlation of CTCs with disease progression in Indian oral cancer patients "OncoDiscover" is a fast, highly sensitive, and affordable (~$120) CTC nanosystem validated in 100 HNC patients to meet global medical needs. Background Liquid biopsy technologies are often unaffordable and unavailable in developing countries, despite these regions having the highest cancer burden and mortality rates. Current circulating tumor cell (CTC) technologies face significant clinical concerns, including non-specificity, low efficiency, high blood volume requirements, long turnaround times, and exorbitant costs (~$900–$1,400). We report an extremely low-cost, innovative nanosystem for the rapid enumeration of CTCs with higher specificity and efficiency. Methods We designed a nanosystem mediated by the conjugation of anti-EpCAM through a multi-reactive glutathione spacer, a carbon allotrope, and an amine-terminated dendrimer. The platform was evaluated for enhanced aqueous dispersibility and increased interaction with CTCs for rapid isolation and enumeration in 100 head and neck cancer (HNC) patients. These patients had various primary tumor sub-sites, including the oral cavity, larynx, hypopharynx, oropharynx, nasopharynx, salivary gland, and thyroid. The captured cells were immunostained, and the optimal fluorescence acquisition intensity was validated by accounting for CTCs with CK18 protein expression. Our method achieved the complete elimination of false-positive normal cell (NC) counts. The analysis was performed using only 1.5 ml of collected blood samples. Results The CTC distribution in the cohort study ranged from 1 to 85 cells per 1.5 ml of blood. In more than 80% of patients' CTCs, the quantitative estimation of anti-CK18 protein overexpression indicated an intensity approximately 10-fold higher than that of normal cells. Compared to treatment-naive, recurrent, and disease-free patients, the spread of CTC numbers across the clinical range appeared to be tight (close to the mean value). The CTC enumeration sensitivity linearity was ~99.2%, and the complete enumeration process time was under 3 hours per 1.5 ml of blood. Consequently, an efficient, rapid, and affordable CTC platform was designed and clinically validated. Conclusions The "OncoDiscover" liquid biopsy technology for CTC enumeration is poised to revolutionize the field due to its high sensitivity and affordability (~$120). It addresses a major unmet medical need in the developing world. 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 June 2022 ASCO 2022: CTCs as a biomarker for monitoring: Disease progression, treatment response, and minimal residual disease. Study of 127 patients shows CTCs are a dynamic biomarker for monitoring disease progression and therapy response in advanced epithelial cancers. Background To analyze the role of circulating tumor cells (CTCs) as a confirmatory personalized biomarker for monitoring disease progression, disease burden, and minimal residual disease in epithelial origin cancers. Methods In this retrospective study, 127 patients with colorectal, breast, and ovarian cancer at stage III and IV were analyzed. The patients were at various stages of intensive chemo and radiotherapy while the CTCs were isolated and enumerated from 1.5 ml of blood. The decision to continue chemotherapy or change to oral metronomic therapy was based on the presence of circulating tumor cells in Stage III. While in stage IV, serial measurement of CTCs guided therapy. CTCs were isolated using the OncoDiscover platform possessing EpCAM antibody-based immunomagnetic targeting of magnetic nanoparticles after RBC lysis. CTCs were imaged and identified as CK18+ and CD45- cells showing a well-defined nucleus using a motorized fluorescence microscope operational with a monochrome camera. CTCs were enumerated using automated image analysis software and counts were expressed as the number per 1.5 ml of blood. Results In this retrospective study, we analyzed blood samples from 127 patients with advanced-stage epithelial cancers (breast: 50%, ovarian: 27%, colorectal: 23%) for the presence of CTCs. Amongst those, 52% showed the presence of CTCs (breast: 52%, ovarian: 46%, colorectal: 58%). The CTC count ranged between 1-5 / 1.5 ml of blood with mean and median values of 2 and 1. Among the CTC positive population, the majority had a CTC count of 1 (44.4%), while more than 2 CTCs were observed in 11% of the population. CTC clusters were detected in 13% of the population, which predominantly were stage IV patients. 67% among the follow-up patients showed a decrease in CTC count from the baseline due to the prescribed treatment, while 22% of patients showed an increase in CTC count from the baseline. 11% of patients did not show a change in CTC count from the baseline. When CTC count was investigated as an independent variable to monitor the therapeutic response, it correlated well with positive or negative outcomes. In a few representative cases, the reduction of CTC numbers from the basal value was indicative of effective treatment. Exceptionally, in a representative colorectal cancer case, a PET scan showed no primary as well as secondary tumor burden, but the presence of CTCs in blood led to further investigating an abdominal MRI that indicated multiple liver lesions suggesting micro-metastasis. Subsequent to SIRT treatment, the patient showed complete tumor regression and the absence of CTCs in peripheral blood. Conclusions Our data suggest that CTCs can serve as a dynamic intermittent biomarker for monitoring disease progression in advanced stages and assessing the therapeutic response, thus emphasizing the role of CTCs in personalized cancer management. 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

Manuscript | 17 April 2015 Manuscript:Calcium phosphate nanocapsule crowned multiwalled carbon nanotubes for pH triggered intracellular anticancer drug release Calcium phosphate–capped carbon nanotubes enable pH-triggered intracellular release of doxorubicin, preventing premature drug leakage and improving targeted cancer therapy. We report calcium phosphate (CaP) nanocapsule–crowned multiwalled carbon nanotubes (CNT–GSH–G4–CaP) as a novel platform for the intracellular delivery of an anticancer drug. As a proof of concept, the CNT–GSH–G4–CaP system demonstrates the release of the anticancer drug doxorubicin hydrochloride (DOX) within intracellular lysosomes from the interior cavity of the CNT through pH-triggered CaP dissolution. Importantly, we found that CNTs capped with a CaP nanolid can efficiently prevent premature drug release at physiological pH, while promoting DOX release in more acidic environments, such as those found in subcellular compartments like lysosomes (pH ≈ 5.0). This “zero premature release” characteristic is of significant clinical importance for delivering cytotoxic drugs, as it helps reduce systemic toxicity and enhances the effectiveness of anticancer treatment. We envision that this pH-triggered CaP-crowned CNT nanosystem could lead to a new generation of self-regulated platforms for the intracellular delivery of a wide range of anticancer drugs. View Manuscript 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 Comparative analysis of circulating tumor cell distribution with PD-L1 expression in baseline and follow ups patients across cancer types. This multi-cancer study shows CTC and PD-L1 prevalence across Indian patients, supporting minimal residual disease monitoring and personalized cancer care. Background India presents a diverse genetic pool with varying cancer incidence patterns. Common cancers in the Indian population include head and neck, lung, breast, colorectal, prostate, ovarian, and gastrointestinal cancers. Understanding the distribution of circulating tumor cells (CTCs) across these cancers may help account for cellular minimal residual disease (MRD) and early recurrence in solid tumors. Surgery with curative intent can be further evaluated for residual disease using dual biomarkers such as ctDNA and CTCs. Methods In this retrospective analysis, peripheral blood samples from 5,935 patients across various cancer types—including head and neck, lung, breast, colorectal, prostate, ovarian, and gastrointestinal cancers—were evaluated for the presence of CTCs, with and without PD-L1 overexpression and CTC clusters. CTCs were detected using the OncoDiscover platform approved by CDSCO in 1.5 mL of peripheral blood. The platform utilizes a multifunctional magneto-nanosystem mediated by anti-epithelial cell adhesion molecule (EpCAM) antibodies. CTCs were confirmed as EpCAM⁺, CK18⁺, DAPI⁺, and CD45⁻ cells. PD-L1 expression on CTCs was analyzed using linear fluorescence intensity gradients acquired through an automated Zeiss microscope. Additionally, a computational model was developed to evaluate CTC frequency, mean distribution, regression analysis, and normal probability plots to assess predictability across cancer types, age groups, stages, and genders. Results The study included 5,935 patient blood samples, comprising 90.07% baseline and 9.92% follow-up samples. CTC counts ranged from 1 to 10 per 1.5 mL of blood, with a mean value of 1.12. Among the patients, 69.87% (n = 2,854) demonstrated PD-L1 expression on their CTCs, with a mean value of 0.99. The 51–60-year age group exhibited the highest proportion of both total CTCs (19.16%, n = 1,137) and PD-L1–positive CTCs (19.71%, n = 805). Most CTC clusters were identified in breast, colorectal, and endometrial cancers. Pancreatic cancer patients showed the highest mean CTC count (1.4), whereas laryngeal cancer samples had the lowest mean count (0.78). The computational model indicated that the 51–60-year age group had the highest impact on cancer prevalence and mean CTC distribution. The model also demonstrated a strong correlation between blood-based outcomes and normal probability scores. Conclusions Higher CTC counts were strongly associated with advanced disease stages, particularly in cancers prone to hematogenous spread, such as breast, lung, and prostate cancers. Incorporating CTC profiling from baseline into diagnostic and surveillance strategies may enhance personalized cancer management. The presence of CTCs in disease-free survival (DFS) settings suggests potential links to poor therapeutic response, disease progression, and minimal residual disease. 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 | 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