The tumor objective response rate(ORR)is an important parameter to demonstrate the efficacy of a treatment in oncology.The ORR is valuable for clinical decision making in routine practice and a significant end-point f...The tumor objective response rate(ORR)is an important parameter to demonstrate the efficacy of a treatment in oncology.The ORR is valuable for clinical decision making in routine practice and a significant end-point for reporting the results of clinical trials.World Health Organization and Response Evaluation Criteria in Solid Tumors(RECIST)are anatomic response criteria developed mainly for cytotoxic chemotherapy.These criteria are based on the visual assessment of tumor size in morphological images provided by computed tomography(CT)or magnetic resonance imaging.Anatomic response criteria may not be optimal for biologic agents,some disease sites,and some regional therapies.Consequently,modifications of RECIST,Choi criteria and Morphologic response criteria were developed based on the concept of the evaluation of viable tumors.Despite its limitations,RECIST v1.1 is validated in prospective studies,is widely accepted by regulatory agencies and has recently shown good performance for targeted cancer agents.Finally,some alternatives of RECIST were developed as immune-specific response criteria for checkpoint inhibitors.Immune RECIST criteria are based essentially on defining true progressive disease after a confirmatory imaging.Some graphical methods may be useful to show longitudinal change in the tumor burden over time.Tumor tissue is a tridimensional heterogenous mass,and tumor shrinkage is not always symmetrical;thus,metabolic response assessments using positron emission tomography(PET)or PET/CT may reflect the viability of cancer cells or functional changes evolving after anticancer treatments.The metabolic response can show the benefit of a treatment earlier than anatomic shrinkage,possibly preventing delays in drug approval.Computer-assisted automated volumetric assessments,quantitative multimodality imaging in radiology,new tracers in nuclear medicine and finally artificial intelligence have great potential in future evaluations.展开更多
Since the onset of the HIV epidemic,assessing CD4+T-cells has become a routine procedure for evaluating immune deficiency,with flow cytometry established as the gold standard.Over time,various strategies and platforms...Since the onset of the HIV epidemic,assessing CD4+T-cells has become a routine procedure for evaluating immune deficiency,with flow cytometry established as the gold standard.Over time,various strategies and platforms have been introduced to improve CD4+cell enumeration,aiming to enhance the performance of diagnostic devices and bring the service closer to patients.These advancements are particularly critical for low-resource settings and point-of-care applications,where the excellent performance of flow cytometry is hindered by its unsuitability in such environments.This work presents an innovative electrochemical microfluidic device that,with further development,could be applied for HIV management in low resource settings.The setup integrates an electrochemical sensor within a PDMS microfluidic structure,allowing for on-chip electrode functionalization and cell detection.Using electrochemical impedance spectroscopy,the biosensor demonstrates a linear detection range from 1.25×105 to 2×106 cells/mL,with a detection limit of 1.41×105 cells/mL for CD4+cells isolated from blood samples,aligning with clinical ranges for both healthy and HIV+patients.The biosensor shows specificity towards CD4+cells with negligible response to monocytes,neutrophils,and bovine serum albumin.Its integration with a microfluidic chip for sensor fabrication and cell detection,compact size,minimal manual handling,ease of fabrication,electrochemical detection capability,and potential for multiplexing together with the detection range make the device particularly advantageous for use in low-resource settings,standing out among other devices described in the literature.This study also investigates the integration of a microfluidic Dean Flow Fractionation(DFF)chip for cell separation.展开更多
文摘The tumor objective response rate(ORR)is an important parameter to demonstrate the efficacy of a treatment in oncology.The ORR is valuable for clinical decision making in routine practice and a significant end-point for reporting the results of clinical trials.World Health Organization and Response Evaluation Criteria in Solid Tumors(RECIST)are anatomic response criteria developed mainly for cytotoxic chemotherapy.These criteria are based on the visual assessment of tumor size in morphological images provided by computed tomography(CT)or magnetic resonance imaging.Anatomic response criteria may not be optimal for biologic agents,some disease sites,and some regional therapies.Consequently,modifications of RECIST,Choi criteria and Morphologic response criteria were developed based on the concept of the evaluation of viable tumors.Despite its limitations,RECIST v1.1 is validated in prospective studies,is widely accepted by regulatory agencies and has recently shown good performance for targeted cancer agents.Finally,some alternatives of RECIST were developed as immune-specific response criteria for checkpoint inhibitors.Immune RECIST criteria are based essentially on defining true progressive disease after a confirmatory imaging.Some graphical methods may be useful to show longitudinal change in the tumor burden over time.Tumor tissue is a tridimensional heterogenous mass,and tumor shrinkage is not always symmetrical;thus,metabolic response assessments using positron emission tomography(PET)or PET/CT may reflect the viability of cancer cells or functional changes evolving after anticancer treatments.The metabolic response can show the benefit of a treatment earlier than anatomic shrinkage,possibly preventing delays in drug approval.Computer-assisted automated volumetric assessments,quantitative multimodality imaging in radiology,new tracers in nuclear medicine and finally artificial intelligence have great potential in future evaluations.
基金funding from Santander postgraduate mobility awards and Department of Electronic&Electrical Engineering,University of BathR.S.was funded through UK Engineering and Physical Sciences Research Council grant number EP/V040189/1.
文摘Since the onset of the HIV epidemic,assessing CD4+T-cells has become a routine procedure for evaluating immune deficiency,with flow cytometry established as the gold standard.Over time,various strategies and platforms have been introduced to improve CD4+cell enumeration,aiming to enhance the performance of diagnostic devices and bring the service closer to patients.These advancements are particularly critical for low-resource settings and point-of-care applications,where the excellent performance of flow cytometry is hindered by its unsuitability in such environments.This work presents an innovative electrochemical microfluidic device that,with further development,could be applied for HIV management in low resource settings.The setup integrates an electrochemical sensor within a PDMS microfluidic structure,allowing for on-chip electrode functionalization and cell detection.Using electrochemical impedance spectroscopy,the biosensor demonstrates a linear detection range from 1.25×105 to 2×106 cells/mL,with a detection limit of 1.41×105 cells/mL for CD4+cells isolated from blood samples,aligning with clinical ranges for both healthy and HIV+patients.The biosensor shows specificity towards CD4+cells with negligible response to monocytes,neutrophils,and bovine serum albumin.Its integration with a microfluidic chip for sensor fabrication and cell detection,compact size,minimal manual handling,ease of fabrication,electrochemical detection capability,and potential for multiplexing together with the detection range make the device particularly advantageous for use in low-resource settings,standing out among other devices described in the literature.This study also investigates the integration of a microfluidic Dean Flow Fractionation(DFF)chip for cell separation.
