FISH-based Determination of HER2 Status in Circulating Tumor Cells Isolated With the Microfluidic CEE™ Platform

Cancer Genet. 2011 Nov;204(11):589-95. doi: 10.1016/j.cancergen.2011.10.011.


Determination of HER2 status in breast cancer patients is considered standard practice for therapy selection. However, tumor biopsy in patients with recurrent and/or metastatic disease is not always feasible. Thus, circulating tumor cells (CTCs) are an alternative source of tumor cells for analysis of HER2. An antibody cocktail for recovery of variable, high- and low-, EpCAM-expressing tumor cells was developed based on FACS evaluation and then verified by CTC enumeration (based on CK and CD45 staining) with comparison to EpCAM-only and with CellSearch® (n=19). HER2 fluorescence in situ hybridization (FISH) on all (CK+ and CK-) captured cells was compared to HER2 status on the primary tumors (n=54) of patients with late stage metastatic/recurrent breast cancer. Capture of low EpCAM-expressing tumor cells increased from 27% to 76% when using the cocktail versus EpCAM alone, respectively. Overall, CTC detection with the OncoCEE™ platform was better compared to CellSearch® (68% vs. 89%, respectively), and a 93% concordance in HER2 status was observed. HER2 FISH analysis of CK+ and CK- CTCs is feasible using the CEE™ platform. Although larger clinical studies are warranted, the results demonstrate adequate sensitivity and specificity as needed for incorporation into laboratory testing.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / pathology*
  • Cell Separation / methods*
  • Creatine Kinase / blood
  • Female
  • Humans
  • In Situ Hybridization, Fluorescence / methods*
  • Leukocyte Common Antigens / blood
  • Microfluidic Analytical Techniques / methods*
  • Middle Aged
  • Neoplastic Cells, Circulating / chemistry*
  • Receptor, ErbB-2 / blood*


  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Creatine Kinase
  • Leukocyte Common Antigens
  • PTPRC protein, human