DEEN
maintrac

maintrac®

Circulating Tumor Cells
Prognosis and Therapy Monitoring

DIAGNOSIS: CANCER

A cancer diagnosis marks a profound turning point in the lives of patients and their families, bringing with it not only emotional and physical challenges but also far-reaching changes.

Following a diagnosis of a malignant tumor, you are now confronted with significant decisions and uncertainties regarding the course of your treatment and the road ahead.

The greatest danger posed by a malignant tumor lies in its ability to spread and form metastases. These secondary tumors can develop in distant, vital organs — far from the original site — and may become life-threatening. Metastases occur when tumor cells break away and travel, most commonly via the bloodstream. For this reason, it is crucial to monitor the movement and behavior of these circulating tumor cells closely.

maintrac® supports the development of a personalized and effective treatment plan tailored to your individual needs — while also monitoring the progress and effectiveness of your therapy.

MAINTRAC® LIQUID BIOPSY

Innovative laboratory diagnostics at every stage of cancer treatment—before, during, and after.

Maintrac® is a highly sensitive, minimally invasive microscopic technique for detecting viable tumor cells circulating in the bloodstream, applicable in around 90% of all carcinomas. The procedure enables the early identification of tumor recurrence — prior to detection through imaging — allowing for timely therapeutic action.

maintrac® enables the evaluation of therapy efficacy in solid tumors and supports the estimation of metastatic potential. Combined with stemtrac®, it may contribute to increased survival rates and enhanced quality of life for patients.

HOW THE MAINTRAC® PROCEDURE WORKS

Due to the high sensitivity of the procedure, CETCs/CTCs can be detected shortly after the diagnosis of a primary tumor, enabling prompt and targeted therapeutic decision-making. The ability to detect tumor cells at such an early stage is largely due to the exceptional sensitivity of the maintrac® method. Unlike other techniques, the cells are not fixed, isolated, or enriched, but analyzed in real time directly from the blood sample.

MAINTRAC® – BLOOD-BASED MONITORING OF TUMOR ACTIVITY


maintrac® enables a direct view of the tumor condition and the ability to assess the effectiveness of your ongoing therapy—making timely treatment adjustments possible when necessary.


maintrac® is generally applicable to all carcinomas, meaning tumors of epithelial origin. It is employed for monitoring the course of disease after a confirmed primary tumor diagnosis. Incidents such as injuries, burns, or surgical procedures may also cause a short-term rise in epithelial cells in the blood. Unlike tumor cells, epithelial cells derived from healthy tissue are typically eliminated from the blood within a matter of days to a few weeks. In contrast, epithelial tumor cells may continue to circulate in the blood or remain dormant in tissue for years. Therefore, a thorough understanding of the patient’s clinical context is crucial.

BEFORE, DURING, AND AFTER CANCER TREATMENT

Innovative Diagnostics for the Best Possible Outcomes in Cancer Therapy

maintrac®
QUANTIFICATION OF TUMOR CELLS
Prior to initiating therapy (including neoadjuvant chemotherapy, post-surgical treatment, or subsequent chemotherapy), cell counts can be utilized to assess the residual tumor burden.
maintrac®
TESTING HOW CANCER CELLS RESPOND TO TREATMENT
Do the drugs, cytotoxic substances, or hyperthermia treatments being considered or already applied show the expected effect on my circulating tumor cells? This can be assessed prior to and during therapy.
maintrac®
THERAPY-RELEVANT CHARACTERISTICS
Do the tumor cells circulating in my blood have the characteristics needed to respond to a specific therapy?
stemtrac®
TUMOR SPHERES
Are there circulating tumor cells in my blood capable of proliferation and tumor sphere formation, indicating characteristics of circulating tumor stem cells? This allows for an assessment of metastatic potential.

When Should maintrac® Be Considered?

maintrac® testing is recommended:

  • Before neoadjuvant chemotherapy
  • Before surgery
  • 3 weeks after surgery
  • 2–3 weeks after a chemotherapy cycle
  • 2–3 weeks after completion of therapy
  • During hormone or maintenance therapy
  • During a therapy-free interval

maintrac®

QUANTIFICATION OF TUMOR CELLS

Treatment Monitoring

Direct observation of the remaining tumor burden:

The maintrac® cell count allows for therapeutic monitoring and real-time assessment of minimal residual disease in patients with both primary and metastatic tumors — often before changes can be detected through imaging.

Serial maintrac® cell count analyses performed every 3–6 months provide insight into the dynamics of circulating tumor cell levels.

Clinical Applications:

  1. Before treatment: to establish a baseline
  2. During treatment: to assess the effectiveness of ongoing therapy and adjust it if necessary
  3. After treatment: to monitor for potential recurrence following completion of therapy
  4. In cases of progression or resistance: to evaluate how the cancer responds to new therapies or to detect resistance at an early stage

Repeat maintrac® Cell Counting

Even during long-term treatments — such as (anti-)hormone therapy — we can monitor whether the number of circulating tumor cells remains stable or continues to decrease. This is a positive sign, indicating that the remaining cells are dormant. Under these conditions, we very rarely observe a recurrence of the tumor. However, if the cell count rises, it may indicate renewed tumor activityand could be a reason to adjust the therapy.

HOW OFTEN SHOULD CELL COUNTING BE PERFORMED?

Monitoring

Tumor cells in the blood are counted using a specialized maintrac® blood analysis. The frequency of these analyses depends on your individual situation. In the initial phase — after diagnosis — the cell count should be checked approximately every three months. If the results remain stable, the interval between analyses can be extended.

WHAT DOES AN INCREASE OR DECREASE IN CELL COUNT INDICATE?

Treatment Monitoring

A decrease in the number of tumor cells in the blood suggests that the therapy is effective. An increase may prompt the physician to modify the treatment strategy.

Maintrac® cell counting provides additional diagnostic clarity and supports informed decision-making throughout your treatment.

Why regular cell counting throughout the course of therapy is a meaningful and valuable approach.

maintrac® cell counting enhances diagnostic precision and aids in making well-informed treatment decisions.

Even during the ongoing course of long-term therapy — such as (anti-)hormone treatment — we can monitor whether the number of circulating tumor cells remains stable or decreases. This is a positive sign, indicating that the remaining cells are dormant. Under these conditions, we very rarely observe a recurrence of the tumor. However, if the cell count increases, it may signal renewed tumor activity and could be a reason to adjust the therapy.

maintrac®

DRUG SENSITIVITY TESTING

Assessment of the efficacy of therapeutic compounds, cytotoxic agents, and hyperthermia

Individualized pre-testing of planned treatments on patient-derived circulating tumor cells

Clinical Applications:

During and after therapy, in follow-up care, and in metastatic disease.

Patients are typically recommended to receive chemotherapy either prior to surgery (neoadjuvant) or following surgery (adjuvant). Before treatment begins, circulating tumor cells in the blood can be analyzed to assess which of the proposed drugs are most effective in targeting them.

This enables the selection of the most effective treatment, personalized and optimized for the individual patient.

Repeating maintrac® Cell Counting

Subsequently, we can evaluate the effectiveness of the therapy by observing whether the tumor cells are being eliminated and whether their number in the bloodstream is declining. This approach has been investigated in a wide range of tumor types and treatment regimens.

MAINTRAC® DRUG SENSITIVITY TESTING

When is it useful to test the effectiveness of a therapy?

After initial diagnosis, before treatment begins

In metastatic disease, before starting a new therapy

In cases of disease progression during ongoing treatment

The degree to which different substances are effective can vary depending on the tumor type, stage of the disease, previous treatments, and individual patient factors.

HOW EFFECTIVE IS YOUR CHEMOTHERAPY?

Detection and Therapy

In patients with malignant tumors, maintrac® is used to detect tumor cells that have entered the bloodstream. Chemotherapy aims to eliminate these circulating cells. Drug efficacy testing evaluates how effective the tested substances are — the greater the number of cells destroyed by a drug, the more effective it is considered to be.

Adjuvant Therapy

Neoadjuvant Therapy

Therapy for Metastatic Disease

WHICH MEDICATIONS WORK BEST FOR YOU?

A blood sample reveals which medications are most effective at destroying circulating tumor cells in your blood.

Based on the equivalent of a daily dose, selected medications are tested in your blood sample — either prior to or during chemotherapy — to identify which substance is most effective in targeting and destroying your circulating tumor cells.

maintrac® drug testing offers added diagnostic certainty and supports more informed decision-making during treatment.

maintrac®

THERAPY-RELEVANT CHARACTERISTICS

Some therapies are only effective if the tumor cells exhibit certain characteristics. This provides important insights into whether the cells are likely to respond — or not respond — to the treatment.

As the disease progresses, the residual circulating tumor cells may undergo changes that render them resistant to the initial treatment.

The properties of the tumor cells can be analyzed at any stage of treatment, enabling early evaluation of whether the current therapy remains effective.

DO TUMOR CELL CHARACTERISTICS CHANGE OVER TIME?

Treatment is usually based on the characteristics of the cells found in the tumor tissue. However, therapy can eliminate the sensitive cells, while resistant cells may remain. As a result, the properties of the circulating tumor cells in the blood can change, and the treatment must be adjusted accordingly.

WHAT TUMOR CELL PROPERTIES ARE RELEVANT FOR IMMUNOTHERAPY?

Tumor cells can evade immune system detection. A key factor in this process is the expression of PD-L1, which can be identified on tumor cells. This characteristic is significant for immunotherapy, as it influences the potential effectiveness of the treatment.

stemtrac®

TUMOR SPHERES

Biomarkers for Metastasis and Estimating the Risk of Spread

stemtrac®Analysis

Using stemtrac®, it is possible to identify circulating tumor cells with growth potential—an important factor in the formation of metastases. These cells can subsequently be addressed with targeted therapies.

In this process, white blood cells are cultured in special flasks for 2–3 weeks under controlled conditions. Tumor cells with growth potential form small, spherical clusters — tumor spheres — originating from a parent cell and its daughter cells. These tumor spheres correspond to tumor stem cells. The greater the number of tumor spheres, the more aggressive the tumor is—and the higher the risk of metastasis.

Clinical Approach:

The stemtrac® analysis can be performed in combination with maintrac® in the following situations:

  • After completion of therapy, to assess the risk of metastasis
  • In complete remission, if CETC levels begin to rise
  • In cases of disease progression
  • When CETC levels are low or undetectable

WHAT DOES THE GROWTH OF TUMOR SPHERES INDICATE?

Tumor sphere growth suggests that a particularly aggressive group of tumor cells is present in the blood-cells that grow easily and are likely involved in the formation of metastases.

DOES THE NUMBER OF TUMOR SPHERES MATTER?

Our findings show that patients with over 350 tumor spheres per milliliter of blood have a higher probability of existing metastases. In healthy control subjects, tumor sphere growth has not been detected.

MAINTRAC® COURIER SERVICE

Would you like your blood sample to be picked up by a courier service? We’ll be happy to assist you with the arrangement.

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