Abstract

Circulating tumor cells (CTCs) are gaining momentum as a diagnostic tool and therapeutic target. CTC clusters are more metastatic, but harder to study and characterize, because they are rare and the methods of isolation are mostly focused on single CTCs. This review highlights the recent advances to our understanding of tumor cell clusters with the emphasis on their composition, origin, biology, methods of detection, and impact on metastasis and survival. New approaches to therapy, based on cluster characteristics are also described.

Highlights

  • Breast cancer is the most common invasive cancer in women and remains the second leading cause of cancer-related death in women after lung cancer

  • Significant improvement in early diagnostic in recent years followed by new methods of treatment led to a reduction in mortality but still metastatic breast cancer (MBC) remains incurable

  • Different types of circulating tumor cells (CTCs) clusters, their features, detection methods, and their impact on metastasis and treatment is described in this review

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Summary

Introduction

Breast cancer is the most common invasive cancer in women and remains the second leading cause of cancer-related death in women after lung cancer. Significant improvement in early diagnostic in recent years followed by new methods of treatment led to a reduction in mortality but still metastatic breast cancer (MBC) remains incurable. This is mainly due to morphological and molecular heterogeneity between tumors as well as within a single tumor, which may be responsible for acquisition of the resistance to treatment. Analyzing the molecular profile of CTCs can facilitate development of personalized treatment for each patient, which will avoid unnecessary or ineffective treatment [5,9] It seems that in the future analysis of cancer cells in the collected peripheral blood (liquid biopsy) will be included into screening diagnostics, which would enable the detection and monitoring of cancer on the basis of a blood test. Different types of CTC clusters, their features, detection methods, and their impact on metastasis and treatment is described in this review

CTC Clusters
Examples single
CTC-Neutrophil Clusters
Macrophage-Tumor Cell Fusion
The Origin of CTC Clusters
Stemness
Epithelial-Mesenchymal Plasticity
Cell-Cell Junctions
CTC Clusters and Their Impact on Survival
Findings
Conclusions
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