Table 1 A comparison of all the currently available CTC methods using whole blood, where each method is compared with the other methods and with the only FDA-approved technique. From a clinical perspective, we found the data describing the clinical detection to be the most important. This table shows the immunoaffinity
From: Technologies for circulating tumor cell separation from whole blood
| Separation category subcategory | Technology | Company | Selection criteria | Key features | Capture efficiency | Purity | Recovery | Viability | Sample volume | Throughput | Clinical detection |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Immunoaffinity | CellSearcha [47,48,49] | Menarini-Silicon Biosystems | EpCAM | FDA approved for advanced breast, prostate, and colorectal cancers; ferrofluid nanoparticles; cannot process whole blood | ≥ 85% | Nonviable | 7.5 ml | 71.4% (35/49) | |||
| Immunomagnetic positive enrichment | MagSweeper [50] | Stanford University | EpCAM | High-purity live cells | 62–70% | > 50% | Viable | 9 ml | 9 ml/h | 100% (17/17) | |
| MACS [51] | Miltenyi Biotech | EpCAM | Pos/neg enrichment; high surface area to volume; difficult to use with whole blood | Viable | |||||||
| IMS [52] | EpCAM | Low background leukocytes (not tested on clinical samples) | 84–100% | Mostly viable | |||||||
| Strep-tag [53] | Wuhan University | EpCAM, HER2, EGFR | Uses antibodies simultaneously; low sample volume | 79% | N/A | 70% | 85% | 1 ml | N/A | 100% (17/17) | |
| Microfluidic positive immunocapture | HTMSU [54,55,56] | EpCAM | Single-step separation; low volumes of blood; conductivity-based enumeration | 100% | 96% | 80% | 1 ml | 1–2 ml/h | No clinical trial | ||
| CTC-Chip [57] | EpCAM | Micro vortex increases the efficiency; various CTC-specific antigens can be used | 65% | 52–67% | > 60% | Viable | 2.7 ml (average) | 1–2 ml/h | 99% (115/116) | ||
| GEDI chip [58] | PSMA/HER2 (+ size selection) | Functional assays in situ; size and collision inclination dependency | 85% | 68% | Viable | 1 ml | |||||
| Microfluidic immunocapture + nanomaterials | GO chip [59,60,61] | EpCAM | Graphene oxide nanosheets; easy fabrication; high purity | 84–95% | High | 91–95% | 92% | 1 ml | 1–3 ml/h | 67–100% (2/3, 8/10, and 20/20) | |
| Microfluidic SiNP platform [62] | EpCAM | Antibody-coated silicone nanopillars for capture enhancement; 1.5–3.0-psi pressure | > 95% | 1 ml | 1 ml/h | 77% (20/26) | |||||
| NP-HBCTC-Chip [63] | EpCAM, HER2, EGFR, or cocktail | Antibody-coated gold nanoparticles for capture enhancement | > 90% | 91–92% | 87–93% | 3.5 ml | 1 ml/h | 100% (4/4) | |||
| Negative immunomagnetic enrichment | EasySep [64] | StemCell | CD45 | Easy-to-use batch separation; high background | 79% | 42% | 0.5–2 ml | 1–4 ml/h | No clinical trial |