According to statistical data, lung cancer is one of the leading causes of death globally and in Taiwan,
resulting in high mortality rates. Therefore, the CTC-FAST team focused on lung cancer,
aiming to early detect signs of cancer metastasis to assist physicians in effectively preventing cancer spread and ultimately reducing the number of deaths due to lung cancer.
Furthermore, our team is dedicated to providing affordable, high-quality,
and accessible testing technologies, adhering to the core value of "Affordable and Accessible".
In addition to early metastasis detection, to empower our team in preventing the onset of lung cancer,
we actively participated in educational and outreach initiatives aimed at communicating the significance of lung cancer prevention to the public.
Our objective is to enhance awareness among the general population regarding lung cancer and promote the adoption of healthy lifestyles as a fundamental approach to preventing lung cancer.
The following tree diagram clearly illustrates how the CTC-FAST team interacts with society:
On this webpage, we will invite you to join our team on a journey through CTC-FAST,
starting from identifying the target audience, progressing through technological enhancements,
and looking into the future with the aim of contributing to society. Furthermore,
we will introduce how the CTC-FAST team enhances public awareness of lung cancer prevention through education and outreach.
To better understand the current clinical usage of Circulating Tumor Cell (CTC) detectors and plan for future applications of CTC-FAST,
we conducted interviews with medical professionals.
Firstly, through a referral from the Taiwan Association of Thoracic & Cardiovascular Surgery,
we interviewed Dr. Yau-Lin Tseng, Chief of Thoracic Surgery at the School of Medicine, National Cheng Kung University.
Dr. Tseng pointed out that the primary cause of lung cancer-related deaths is that most patients are diagnosed in the advanced or recurrent stages of the disease.
If we could employ CTC detection for early screening of lung cancer, it could potentially increase the chances of early detection and treatment, ultimately improving patient survival rates.
However, Dr. Tseng also noted that the effectiveness of CTC detection in early diagnosis has not been conclusively established. Additionally,
he emphasized the importance of utilizing CTC detection to predict the risk of metastasis for lung cancer patients who often experience recurrence within three years after surgery.
Next, in our interview with Dr. Chih-Ying Liao,
Department of Radiation Oncology, China Medical University Hospital,
we learned that while he had used CTC detection for early cancer screening, the overall results were not ideal. He believes that the ability of CTC in early detection is not yet well-defined.
However, Dr. Liao expressed optimism regarding the clinical significance of CTC detection in predicting the risk of metastasis.
Subsequently, we spoke with Dr. Gi-Ming Lai,
the Executive Director of the Taiwan Cancer Foundation. Dr. Lai pointed out that although Taiwan has advanced imaging examinations like Low-Dose Computed Tomography (LDCT) and Magnetic Resonance Imaging (MRI) for lung cancer,
there is still a lack of an effective platform to monitor the presence of circulating cancer cells in the blood. He believes that CTC detectors can play a crucial role in early cancer metastasis detection,
assisting physicians in treatment decisions and improving the quality of care for lung cancer patients.
Therefore, post-interview, we reevaluated where CTC-FAST could be most effective and decided to focus on assisting patients in predicting the risk of metastasis.
Finally, during our discussion with Dr. Chia-Jui Yen,
Head of the Oncology Division in the Department of Medicine at National Cheng Kung University,
he emphasized that any medical diagnostic device used in a clinical setting must undergo validation for reliability and validity.
Dr. Yen also encouraged us to think about how to make CTC-FAST more effective in assisting physicians in developing medical strategies.
To achieve this, we referred to lung cancer guidelines and other CTC detection reports and established CTC-FAST simulation data and medical treatment reference tables.
While CTC detection is not yet widely used in clinical practice,
medical professionals express confidence in our topic and see the potential for CTC detection to develop in the future.
To make CTC-FAST more user-friendly,
we conducted interviews with a case manager (Zhi-Xuan Lin) and a lung cancer patient (Eva)
in the hope of designing a device that better meets users' needs.
Case manager Lin suggested that the device's design should also consider the anxiety of patients.
After providing Lin with detailed information about CTC-FAST's target audience and its intended usage, she believed that our device has significant advantages.
Patients often spend a lot of time queuing for tests during follow-up visits.
However, CTC-FAST's design allows it to be placed in general medical facilities, effectively distributing healthcare resources and significantly reducing patient waiting times.
Traditional testing usually takes 7 to 14 days to receive reports, causing significant psychological stress for patients. The modular design of CTC-FAST makes report generation more convenient and rapid, with patients typically waiting only half a day to receive test reports,
thus significantly alleviating their anxiety.
Through the Cancer Foundation, we also contacted a patient, “Eva,” for an interview. During the process, we learned that patients undergoing treatment often require frequent follow-up appointments to monitor their condition.
However, the common diagnostic method for lung cancer today primarily involves imaging tests. Patients may have concerns about radiation exposure.
In contrast, CTC-FAST testing involves a non-invasive liquid biopsy, making it a test with no frequency limitations.
Furthermore, the current market price for CTC testing is approximately US$1,000, which can be a significant financial burden for patients who require regular tests every three to six months.
Therefore, our goal is to ensure that the single-test price is US$100, helping patients reduce financial stress and allowing them to move forward without worries.
In addition, we also collected data from the public through surveys to gather their acceptable price range for lung cancer screening. The data we collected also indicates that the public prefers affordable and swift testing.
To assess the technical challenges encountered by current CTC detection methods and explore potential areas for improvement in the future,
we initiated contact with Dr. Mei-Chia Wang,
a medical laboratory scientist referred to us by the Taiwan Society of Medical Laboratory Science.
During the interview, Dr. Wang pointed out that due to the absence of a unified CTC detection technology,
there is a lack of consistency in related research, and the applications are relatively immature. As of now, several detection methods have been developed,
including flow cytometry, immunomagnetic separation, and microfluidic techniques. However, the majority of CTC detection methods rely on the use of antibodies for CTC capture, which exhibit limitations such as suboptimal sensitivity and specificity,
and the need to consider their susceptibility to environmental factors. Recognizing these constraints, CTC-FAST employs a DNA tetrahedron as a replacement for the existing antibody-based technology. This not only reduces environmental restrictions for detection but also ensures that cell integrity is preserved during CTC capture. Furthermore,
CTC-FAST is committed to enhancing detection accuracy and aspires to popularize CTC detection for clinical applications in the future.
After further research, we contacted Mr. Sung-Chi Tsai, the manager of LifeCode Biotech,
and conducted an interview with him to gain insights into any technical deficiencies in CTC-FAST and to evaluate whether our design aligns with market demands.
Manager Tsai pointed out that because CTCs are very rare in the bloodstream, coupled with the three-dimensional space of blood samples within the chamber,
we need to consider how to make CTCs move within the chamber and actively adhere to the DNA tetrahedron we designed. This will facilitate effective detection in subsequent fluorescence testing.
To achieve this, our team has specially designed the main chamber in a diamond shape to prevent CTCs from running into dead ends. During the capture process, blood samples are first allowed to stand still,
followed by shaking to ensure that all of the liquid comes into contact with the chamber walls. In fluorescence detection, microchannels are used to ensure that all fluorescently labeled CTCs are detectable.
To facilitate the seamless progression of our experiments, we enlisted the support of experts, both within and outside the university.
Assistant Professor Bi-Hui Duan was instrumental in our exploration of amplifiers and amplifier circuits, meticulously assessing their amplification capabilities. His contributions ensured the viability of our fluorescence detection experiments.
A.P. Song-Wei Yao provided invaluable guidance in the creation and control of microchannels, a pivotal contribution to our team's endeavors to maintain cell stability within these channels.
Dr. Yen-Ta Tseng's profound expertise guided our effective utilization of FTIR equipment from the Department of Chemical Engineering. Dr. Tseng's generosity extended to providing organic reagents and essential support for our critical tasks.
Under the mentorship of Yu-Hsuan Chen, our progress in protein-related research has been remarkable. Ms.Chen's guidance and expertise have not only streamlined our experimental processes but have also propelled our scientific pursuits forward.
Their contributions have significantly advanced our research efforts, making these experiments not only possible but also highly productive.
We actively engaged with other iGEM teams to exchange valuable insights and enhance our project's feedback. These interactions spanned geographical boundaries, connecting us with diverse teams for a comprehensive perspective on our project. Our collaborative approach fosters a supportive iGEM community that collectively strives for excellence and advances synthetic biology. This benefits not only our project but also the entire iGEM community's growth and development.
During the interviews, healthcare professionals informed us that, although CTC testing in Taiwan complies with Quality Management Systems for medical devices, it has not yet obtained certification related to clinical trials from regulatory bodies such as the U.S. Food and Drug Administration (FDA), Taiwan Food and Drug Administration (TFDA),
or In Vitro Diagnostic (IVD). Consequently, CTC testing cannot be used in hospitals and is limited to clinical experiments or research projects. We were keen to understand the regulatory and certification processes that CTC testing must go through, from manufacturing and production to market entry and eventual clinical application. To do so, we contacted a specialist from the Legal Affairs Department over the phone, who provided insights into the current status of CTC testing in Taiwan and the relevant regulations.
The information gathered has been organized into the table below:
In addition, Dr. Huang mentioned that if we want to popularize CTC testing, it is essential not only to consider the accuracy of the tests but also to establish a standardized process for CTC-FAST. This standardization should not only accelerate the speed of report generation but also make it more convenient for healthcare professionals to operate.
Furthermore, in clinical use, if we intend for CTC-FAST to become a reference indicator for physicians, the test results must be compatible with the patient's clinical treatment condition. This compatibility is necessary to assist doctors in making judgments. Dr. Huang also recommended that we aim for IVD certification as a goal.
To ensure the long-term development of our devices, we have planned different objectives for each period:
After referring to lung cancer guidelines and other reports on CTC testing, we have established a CTC-FAST simulated numerical reference and medical intervention table, aiming to assist physicians more effectively in formulating medical strategies and help customers to clearly understand the significance of the test results.
The CTC-FAST simulated numerical reference and medical intervention table is presented below:
At the same time, in order to enable the device to contribute more effectively to society, our team has referred to SDGs and ESG, hoping to collaborate with the global community towards sustainability.
▲ SDG 3: Ensure healthy lives and promote well-being for all at all ages
▲ SDG 10: Reduce inequality within and among countries
CTC-FAST aims to provide an accessible and convenient method of detection for lung cancer patients by improving the existing CTC testing. It focuses on monitoring the metastasis of lung cancer to assist in the control of the disease's progression and prognosis tracking.
However, as the saying goes, "Prevention is Better Than Cure".
Although our detectors effectively assist patients in monitoring their condition, they cannot reduce the incidence of lung cancer. Therefore, lung cancer prevention should also be our primary goal.
To achieve this goal, we have developed both online and street surveys.
Through these activities, we hope to gain insights into the general public's awareness and expectations regarding testing and their awareness of cancer prevention. These efforts not only help us gather a broader range of opinions and gain a more comprehensive understanding of the current situation but, more importantly, enhance public awareness and understanding of cancer prevention and treatment.
Furthermore, we conducted a comprehensive analysis of the feedback gathered from our distributed online surveys and street interviews. The data we have collected consistently underscores a deficiency in the public's knowledge about lung cancer, as illustrated above.
In parallel, we have established contact with the Formosa Cancer Foundation, which has graciously extended substantial support. The Formosa Cancer Foundation recommended two of its members for interviews, thereby offering invaluable insights into how we can effectively educate the public about lung cancer prevention.
This collaborative endeavor will empower us to formulate a holistic approach to lung cancer prevention education, significantly amplifying the impact of our educational initiatives.
To address the lack of public awareness and preventive concepts regarding lung cancer, our team decided to undertake some educational initiatives. We actively engaged with various groups and participated in planning the following activities to enhance public awareness of the risk factors associated with lung cancer in everyday life and collectively work towards its prevention. Concurrently, we aimed to introduce our project to these audiences,
promoting synthetic biology and iGEM, with the goal of expanding the reach of our team's ideas to a broader audience.
On World Lung Cancer Day, we collaborated with the Chiayi County Private Raytai Social Welfare Foundation to design a lung cancer awareness campaign targeting the high-risk group of middle-aged and elderly individuals.
Our aim was to provide this target audience with more knowledge about lung cancer prevention and screening.
At the Open Lab, we designed synthetic biology experiments for high school students to inspire their interest in iGEM. We introduced them to our team and our current endeavors, while also promoting relevant information on lung cancer prevention.
Furthermore, during the campus exposition and recruitment event, we actively participated in the internal campus campaign. We clarified the content and objectives of the iGEM competition to fellow students, conveyed our team's spirit, and recruited new iGEMers.
In our endeavor to broaden the reach of our project and make it more visible to a wider audience, we have adopted a multifaceted approach. First and foremost, we harnessed the power of social media platforms to disseminate information about our team and our core principles. Through engaging posts, informative graphics, and interactive content,
we strive to capture the attention of online communities and raise awareness of our mission.
Also, we have embraced the traditional yet impactful method of sending postcards. These postcards serve as a bridge to connect with friends and supporters both domestically and internationally. Each postcard carries not only warm greetings but also information about our concept, spreading our message far and wide.
Furthermore, we have collaborated with one of the restaurants within the National Chung Cheng University's canteen to create delicious and nutritious special "bento" meals. These meals not only promote healthy eating but also include information about lung cancer prevention. By blending gastronomy with education, we provide students with a unique opportunity to learn while relishing a wholesome meal.
This comprehensive approach ensures that our project reaches diverse audiences and leaves a lasting impact on individuals' understanding of lung cancer prevention.
CTC-FAST profoundly recognizes the significant threat that lung cancer poses to society. Therefore, we are firmly committed to addressing the high mortality rates associated with lung cancer. We work continuously and tirelessly, focusing on the development of innovative detection technologies, and actively promoting lung cancer prevention.
Our mission is to enhance early detection rates of lung cancer metastasis through synthetic biology, ensuring that patients can receive effective treatment as early as possible. However, our goals extend beyond reducing the mortality of lung cancer; they also include increasing patient survival rates and improving their quality of life.
Therefore, we actively collaborate with professionals from diverse fields, conducting interviews to meet the various needs of society, especially those facing economic difficulties or other challenges.
In addition to our efforts in clinical treatment, we also actively advocate for lung cancer prevention and early screening to help more people identify potential risk factors and take preventive measures, especially those at risk of lung cancer. We firmly believe that through education,
we can enhance lung cancer prevention efforts, bringing greater benefits to society.
Simultaneously, we actively promote the development of synthetic biology, a highly promising field that can provide new methods for early detection and treatment of lung cancer. Through interdisciplinary cooperation, we are dedicated to making a positive impact on society, alleviating the burden of lung cancer on individuals and society, and advancing the field of lung cancer research.
We firmly believe that these practical actions will bring about a better impact on society.
O'Shannessy DJ, Yu G, Smale R, Fu YS, Singhal S, Thiel RP, Somers EB, Vachani A. Folate receptor alpha expression in lung cancer: diagnostic and prognostic significance. Oncotarget. 2012 Apr;3(4):414-25. doi: 10.18632/oncotarget.489. PMID: 22547449; PMCID: PMC3380576.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3380576/