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Abstract
Functional precision medicine offers a promising complement to genomics-based cancer therapy guidance by testing drug efficacy directly on a patient’s tumor cells. Here, we describe a workflow that utilizes single-cell mass measurements with inline brightfield imaging and machine-learning based image classification to broaden the clinical utility of such functional testing for cancer. Using these image-curated mass measurements, we characterize mass response signals for 60 different drugs with various mechanisms of action across twelve different cell types, demonstrating an improved ability to detect response for several slow acting drugs as compared with standard cell viability assays. Furthermore, we use this workflow to assess drug responses for various primary tumor specimen formats including blood, bone marrow, fine needle aspirates (FNA), and malignant fluids, all with reports generated within two days and with results consistent with patient clinical responses. The combination of high-resolution measurement, broad drug and malignancy applicability, and rapid return of results offered by this workflow suggests that it is well-suited to performing clinically relevant functional assessment of cancer drug response.
A pipeline for drug sensitivity testing using cell mass from sample collection to data analysis is presented.
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1 Travera, Medford, USA
2 Dignity Health, Sequoia Hospital, Department of Clinical Research, Redwood City, USA (GRID:grid.415541.0) (ISNI:0000 0000 9827 4667)
3 Weill Cornell Medicine, New York, USA (GRID:grid.5386.8) (ISNI:000000041936877X)
4 Icahn School of Medicine at Mount Sinai, Department of Medicine, Hematology and Medical Oncology, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351)
5 Icahn School of Medicine at Mount Sinai, Department of Medicine, Hematology and Medical Oncology, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Graduate School of Biomedical Sciences, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351)
6 Dana-Farber Cancer Institute, Department of Medical Oncology, Boston, USA (GRID:grid.65499.37) (ISNI:0000 0001 2106 9910)
7 Icahn School of Medicine at Mount Sinai, Department of Medicine, Hematology and Medical Oncology, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Precision Immunology Institute, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Department of Oncological Sciences, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351)
8 Palo Alto Medical Foundation, Division of Vascular and Interventional Radiology, Redwood City, USA (GRID:grid.416759.8) (ISNI:0000 0004 0460 3124)
9 Travera, Medford, USA (GRID:grid.416759.8)