Clinical scores, molecular markers and cellular phenotypes have been used to predict the clinical outcomes of patients with glioblastoma. However, their clinical use has been hampered by confounders such as patient co-morbidities, by the tumoral heterogeneity of molecular and cellular markers, and by the complexity and cost of high-throughput single-cell analysis. Here, we show that a microfluidic assay for the quantification of cell migration and proliferation can categorize patients with glioblastoma according to progression-free survival. We quantified with a composite score the ability of primary glioblastoma cells to proliferate (via the protein biomarker Ki-67) and to squeeze through microfluidic channels, mimicking aspects of the tight perivascular conduits and white-matter tracts in brain parenchyma. The assay retrospectively categorized 28 patients according to progression-free survival (short-term or long-term) with an accuracy of 86%, predicted time to recurrence and correctly categorized five additional patients on the basis of survival prospectively. RNA sequencing of the highly motile cells revealed differentially expressed genes that correlated with poor prognosis. Our findings suggest that cell-migration and proliferation levels can predict patient-specific clinical outcomes.
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The main data supporting the results in this study are available within the paper and its Supplementary Information. The raw and analysed datasets generated during the study are too large to be publicly shared, but they are available for research purposes from the corresponding authors on reasonable request. RNA-seq data are available at the National Center for Biotechnology Information Gene Expression Omnibus under accession no. GSE144610.
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This line of research was supported by the National Cancer Institute through grant nos. R01-CA216855 (to A.Q.-H. and K.K.), R01-CA183804 (to K.K.) and R01-CA124704 (to S.S.M.) and Department of Defense grant no. CA160997 (to V.K.B.). A.Q.-H. was also supported by the Mayo Clinic Clinician Investigator Award and the William J. and Charles H. Mayo Professorship.
MAqCI is the subject of US utility patent applications 15/780,768 and 14/906,055. Intellectual property related to MAqCI is owned by the Johns Hopkins University and licenced to RecurX Bio, Inc., of which K.K. is a co-founder, consultant and board member. K.K. has a financial interest in RecurX Bio, Inc., which is subject to certain restrictions under university policy. The terms of this arrangement are being managed by the Johns Hopkins University in accordance with its conflict of interest policies.
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Supplementary figures, tables and video captions.
Measures of performance, patient characteristics and list of differentially expressed genes from two patients.
Migration of patient-derived primary GBM cells (GBM714) in MAqCI.
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Wong, B.S., Shah, S.R., Yankaskas, C.L. et al. A microfluidic cell-migration assay for the prediction of progression-free survival and recurrence time of patients with glioblastoma. Nat Biomed Eng 5, 26–40 (2021). https://doi.org/10.1038/s41551-020-00621-9