Abstract
The ability to obtain tumor material from cells in the blood of cancer patients provides a significant benefit over the use of tumor tissue as a diagnostic to make treatment decisions. However, the traditionally defined circulating tumor cell (CTC) has been shown to be useful only in some cases. A recently identified type of circulating stromal cell, which appears to be more frequent than CTCs, was found engulfing tumor material at the tumor site and then entering the blood stream. These cells were defined as cancer-associated macrophage-like cells (CAMLs). Together, CTCs and CAMLs may be able to provide information for cancer detection and diagnosis, without the use of tissue. CTCs and CAMLs have many clinical applications, three of which are summarized in this review: for prognosis, as companion diagnostics, and for residual disease monitoring.
Highlights
Clinical Applications of Cancer encompasses numerous subtypes and is the second leading cause of death in the United States
This review describes the type of information circulating tumor cell (CTC) and CAMLs can provide to support prognosis, companion diagnostics, and monitoring of residual disease by a blood test
Since CAMLs are easy to identify by their shape and features, it is possible to eliminate
Summary
Defined circulating tumor cells (CTCs) are actual tumor cells that have entered the blood stream [6–9]. This review describes the type of information CTCs and CAMLs can provide to support prognosis, companion diagnostics, and monitoring of residual disease by a blood test. Filtration by size is a suitable method to consistently capture multiple types of tumorassociated cells in the blood, both CTCs and CAMLs. Filtration can be performed under low pressure using a syringe pump or a vacuum pump [10]. The low auto-fluorescence background of the filter material enables the determination of medium and low expression levels of the marker of interest and provides the ability to accurately measure CAML size. Marker intensity on CAMLs and CTCs are validated using patient samples, and adjustment of reagents and expression levels is required to finalize the scaling criteria
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