{"entity":{"id":"idea-bio2-ctc-culture-functional-testing","kind":"idea","name":"Grow blood-borne tumour cells to test drugs on the cells that actually spread","aka":[],"tldr":"Drug tests normally use cells from the original tumour. Growing the rarer cells found in blood would test drugs against the cells that are actually travelling.","summary":"Cultures and xenografts derived from circulating tumour cells have been established in small-cell lung, breast and prostate cancer, with success rates that rise with CTC burden. They capture the metastasis-competent population and can be sampled repeatedly without a biopsy. Scaling the protocols, publishing failure rates honestly, and linking drug sensitivity to subsequent clinical course would create the first functional assay of metastatic competence.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Metastasis is understood least and studied last): Dillekås et al., Are 90% of deaths from cancer caused by metastases? (Cancer Medicine 2019)","url":"https://doi.org/10.1002/cam4.2474"}],"tags":[],"related":[],"cancers":["sclc","prostate"],"sections":[],"technologies":["liquid-biopsy","functional-drug-testing","organoids","pdx-models"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["caroline-dive","fiona-blackhall"],"bottlenecks":["b-metastasis-biology","b-preclinical-models"],"keyPapers":["paper-dillekas-cancer-med"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Ex vivo models can be established from circulating tumour cells in over 40% of patients with high CTC burden, and their drug sensitivity predicts subsequent clinical response better than sequencing of the archival primary.","rationale":"CTC-derived explant models in small-cell lung cancer reproduce patient chemosensitivity and molecular subtype, and are the field's best worked example. Serial sampling makes resistance trackable in a way tissue biopsy cannot.","test":"Multi-centre protocol harmonisation study in small-cell lung and prostate cancer, reporting establishment rate, time to model and concordance of ex vivo sensitivity with clinical response in 100 patients.","maturity":"preclinical-evidence","actor":"research","cost":"medium","horizonYears":7},"route":"/ideas/idea-bio2-ctc-culture-functional-testing/","neighbours":{"cancer":[{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"},{"id":"sclc","kind":"cancer","name":"Small-cell lung cancer","route":"/cancers/sclc/"}],"technology":[{"id":"functional-drug-testing","kind":"technology","name":"Functional (ex vivo) drug testing","route":"/technologies/functional-drug-testing/"},{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"organoids","kind":"technology","name":"Patient-derived organoids","route":"/technologies/organoids/"},{"id":"pdx-models","kind":"technology","name":"Patient-derived xenografts","route":"/technologies/pdx-models/"}],"person":[{"id":"caroline-dive","kind":"person","name":"Caroline Dive","route":"/people/caroline-dive/"},{"id":"fiona-blackhall","kind":"person","name":"Fiona Blackhall","route":"/people/fiona-blackhall/"}],"bottleneck":[{"id":"b-preclinical-models","kind":"bottleneck","name":"Lab models that fail to predict what happens in patients","route":"/bottlenecks/b-preclinical-models/"},{"id":"b-metastasis-biology","kind":"bottleneck","name":"Metastasis is understood least and studied last","route":"/bottlenecks/b-metastasis-biology/"}],"paper":[{"id":"paper-dillekas-cancer-med","kind":"paper","name":"Are 90% of deaths from cancer caused by metastases?","route":"/key-papers/paper-dillekas-cancer-med/"}]}}