MIRACLE · Magnetic Isolation and moleculaR Analysis of single CircuLating and disseminated tumor cElls on chip

Cancer remains a prominent health concern afflicting modern societies. Continuous innovations and introduction of new technologies are essential to level or even reduce current healthcare spending. As the analysis of occult tumour cells (OTC) in blood or bone marrow is most promising in this respect, MIRACLE aims to develop a low-cost, fully automated, integrated lab-on-a-chip (LOC) system for the isolation, counting and characterization of OTCs starting from clinical samples.A major challenge for OTC detection is their extremely low concentration (below a single cell per mL) in clinical samples. Current detection methods are often based on enrichment techniques followed by cumbersome microscopic analysis of the cell phenotype. Some of these procedure steps have been semi-automated (Cellsearch®, J&J), but the interpretation of the cell morphology requires expertise and remains partially subjective. In contrary to standard phenotyping tests, MIRACLE aims to determine the genotype by integrating all sample processing and detection steps in a miniaturized system. This envisaged, fully-automated MIRACLE test would yield decisive results within half a day for less than 50 EUR, as compared with contemporary diagnostics tests that may take days.With the essential individual modules recently demonstrated on automated chips in a joint project by some of the partners involved (MASCOT FP6 027652), the MIRACLE's consortium is uniquely positioned to lead the project's main objectives to a successful outcome, well ahead of the current state-of-the-art. Combining the team's multidisciplinary and unique expertise avoids unnecessary overlap. Integrating all components into a fully operational LOC platform will represent an immense advance for Europe to cope with interfacing and integration problems generic to microfluidic and smart miniaturized systems. More importantly, the realisation of the MIRACLE vision will revolutionise cancer diagnostics and individualized theranostics.