Fig. 4

TRAIL liposomal therapy efficiently killed CTCs from PC patients (a) Experimental procedure to prepare the liposomal TRAIL therapy. (b) Size (diameter) distribution of nanoscale liposomes for non-conjugated (vehicle control) and conjugated (TRAIL therapy) formulations with TRAIL and E-selectin protein. The superimposed black curve represents the mean of three different runs (mean, n = 3 from 3 batch of liposomes prepared). (c) A scatter dot chart represents the viable CTC counts of samples treated with the vehicle control and TRAIL therapy (median ± range, n = 45 samples from 12 patients) through primary tumor resection. Significance with regard to the cancer treatment (*P < 0.0376) and to TRAIL therapy vs. vehicle control (**P < 0.0058, ***P = 0.0004 and ****P < 0.0001) was calculated in a two-way ANOVA test. (d) Column chart represents the viable CTC percentage treated with vehicle control and with the TRAIL therapy (mean ± SD, n = 45 samples from 12 patients). There was a significant reduction (****P < 0.0001) in cell viability percentage, as calculated in a Wilcoxon paired t test. (e) Column chart represents the viable CTC percentage of samples treated with PBS and with soluble TRAIL (n = 3 samples from 1 patient). Non-significance (P = 0.1994) was calculated in a paired t test. (f) Scatter dot plot that represents the number of CTCs in the form of clusters in samples treated with the vehicle control and with the TRAIL therapy (mean ± range, n = 41 samples from 11 patients). Non-significance (P = 0.0826) was calculated for a Wilcoxon paired t test. (g) Column chart represents the percentage of viable CTCs in clustered form in samples treated with the vehicle control and TRAIL therapy (mean ± SD, n = 25 samples from 10 patients). There was a significant (****P < 0.0001) decrease in viability percentage in clustered CTC with the TRAIL therapy compared with the vehicle control, as calculated in a Wilcoxon paired t test