Abstract
Abstract Metastasis is the main cause of cancer-related death and prevention of metastatic relapse is, therefore, the most important goal of cancer therapy. Distant metastases harbour unique genomic characteristics not detectable in the corresponding primary tumor of the same patient and metastases located at different sites show a considerable intra-patient heterogeneity. Thus, the mere analysis of the resected primary tumor alone (current standard practise in oncology) or, if possible, even re-evaluation of tumor characteristics based on the biopsy of the most accessible metastasis may not reveal sufficient information for treatment decisions. This dilemma can be solved by a new diagnostic concept: Liquid biopsy, i.e., analysis of therapeutic targets and drug resistance-conferring gene mutations on circulating tumor cells (CTCs) and cell-free circulating tumor DNA (ctDNA) released into the peripheral blood from metastatic deposits. In addition, cell-free microRNAs in the peripheral blood of cancer patients may provide real-time insights into the biology of cancer, including the effects of therapeutic interventions. MicroRNA levels in plasma, serum, urine and other body fluids have been used to detect cancer, predict the prognosis and response to therapy. Here the current challenges and future perspectives of CTCs and circulating nucleic acids as biomarkers in clinical oncology will be discussed. Both CTCs and circulating nucleic acids are interesting complementary technologies that can be used in parallel in future trials assessing new drugs or drug combinations. We postulate that the liquid biopsy concept will contribute to a better understanding and prevention of metastatic relapse and progression in cancer patients. Citation Format: Klaus Pantel. Circulating tumor cells versus circulating tumor cell products. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr ED06-03.
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