Maintrac - Quantitative Tumor Cell Number Determination

What is Maintrac(TM)?

Maintrac is a liquid biopsy method to quantify, living, circulating, epithelial tumor cells and to perform chemosensitivity testing. It is world wide scientifcally best evaluated and up to now the only routinely used method to diagnose circulating tumor cells and to perform chemosensitivity testing to select the best working chemotherapy before starting therapy.

In clinical trials Maintrac could show that it can answer the following questions:

  • Realtime monitoring even years after the surgery?
  • 5 years or 10 years Tamoxifen?
  • How to recognize when maintenance therapy does not work?
  • Success control in the adjuvant situation?
  • If the therapy does not work, which way shall I go?

Quantifcation of Circulating Epithelial Tumorcells (CETCs)

Most of the solid tumors are of epithelial origin. Therefore they express epithelial tissue specific antigenes on their surface. These antigens can be stained with an EpCam antibody and counted quantitatively in a defined volume of whole blood.


This method is also suited to select, monitor and guide chemotherapy treatments. Studies show an increase of cell numbers by 10 fold is a significant sign for new/ongoing tumor activity. A steady state or decrease of cell numbers is a good prognostic sign. 

Chemosensitivity Testing

Since with this method the CETCs are isolated alive, even in the first line (guideline) therapy it is possible to select the best working chemotherapeutics.

It is also advised to control the cell numbers every 3 - 6 month during maintenance therapy to detect as early as possible new tumor activity. Imaging systems like MRI, CT-Scans or protein tumor markers are too late to show new tumor activity.

Monitoring of endocrine therapy

End of the endocrine therapy

Very important to understand the difference to other CTC systems:

1. Maintrac is a liquid biopsy method to avoid wrong results which usually come from solid biopsy samples due to tumor inhomogeneity. Maintrac is not isolating tumor cells, it is not "touching", extracting or filtrating the cells. This way no cells are lost, we have a real quantitative relation to the drawns blood sample. That is why Maintrac is the most sensitive CETC counting system in the world.

2. All methods using isolation, filtration or enrichment steps will loose very signifcant amounts of "tumor" cells (often > 90%). Therefore methods using any of those steps are not suited for a quantitative monitoring of cell numbers over the time. And for sure they cannot be used for chemosensitivity testing.

3. Chemosensitivity testing: Maintrac makes a clear destinction between living and dead cells. Together with the quantitative approach a very exact dying rate of cell can be determined.

4. Maintrac does not work with cut offs! Cancer is a very individualistic disease where cut offs will not work. We have patients with quite high cell numbers who are doing fine over many years, unfortunately we have also patients with relatively low numbers who are more unfortunate. The only thing that counts is the trend of the cell number and to control it, best to get it down!

5. We are sure there are many more arguments and questions concerning Maintrac, we would be very pleased to answer all your questions.

Summary here.

Further scientific publications can be found here.