Circulating Tumor Cells: From the Laboratory to the Cancer Clinic.

Ruchi Agashe,Razelle Kurzrock

doi:10.3390/cancers12092361

Ruchi Agashe, Razelle Kurzrock

Open Access

https://doi.org/10.3390/cancers12092361

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Journal: Cancers	Publication Date: Aug 21, 2020
Citations: 24	License type: CC BY 4.0

Affiliation: University of California, San Diego

Abstract

Circulating tumor cells (CTCs) are cells that are shed from tumors into the bloodstream. Cell enrichment and isolation technology as well as molecular profiling via next-generation sequencing have allowed for a greater understanding of tumor cancer biology via the interrogation of CTCs. CTC detection can be used to predict cancer relapse, progression, and survival; evaluate treatment effectiveness; and explore the ex vivo functional impact of agents. Detection methods can be by either immunoaffinity (positive or negative enrichment strategies) or biophysical strategies. CTC characterization, which is performed by DNA, RNA, and/or protein techniques, can predict metastatic potential. Currently, CTC-derived explant models may mimic patient response to chemotherapy and help with studying druggable targets and testing treatments. The Food and Drug Administration has cleared a CTC blood test to enumerate CTCs derived from breast, prostate, and colorectal cancers. In conclusion, liquid biopsies via CTCs provide a non-invasive way to obtain important diagnostic, prognostic, and predictive information in patients with cancer.

Highlights

Circulating tumor cells, or CTCs, are cells that are shed from tumors into the bloodstream.After release from tumors, most CTCs die in the circulation owing to mechanical forces or immune system attack [1]
In a prospective multicenter study, 177 patients with measurable metastatic breast cancer were tested for CTCs before starting new treatment and at first follow up
The number of circulating CTCs before treatment was an independent predictor of progression-free survival (PFS) and OS in patients with metastatic breast cancer [38]

Summary

Introduction

Circulating tumor cells, or CTCs, are cells that are shed from tumors into the bloodstream. After release from tumors, most CTCs die in the circulation (in ~1–2.5 h) owing to mechanical forces or immune system attack [1]. Technology has allowed for the detection of CTCs and their interrogation at the molecular and functional levels [2]. The emerging methods of cell enrichment, isolation, and analysis have given rise to a greater understanding of tumor cancer biology [3]. Molecular profiling of the cells using next-generation sequencing (NGS) allows for a comprehensive analysis of genomic alterations in CTCs [4]. The phenotypic and functional characteristics of the cells may provide information about which types of treatments patients should receive, and CTC enumeration and characterization may be important for determining prognosis [5]

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