Finding Waldo: the emerging field of circulating tumor cells.

Abstract

Here is a dream: find and destroy every tumorous cell in the body, especially those that get into the blood and mercilessly rove for other sites to inhabit. Some scientists in the field of circulating tumor cell (CTC)3 research feel we are closer to realizing this dream than ever before. The first CTC was identified in 1869. Dr. Peter Kuhn, a professor of biology at the University of Southern California, shared with Clinical Chemistry 3 major advances that provide the foundation for his contributions to the field. To begin with, the work behind the first US Food and Drug Administration–approved diagnostic test for CTCs, CellSearch®, demonstrated that it was possible to find CTCs and also showed that their volume was related to the evolution of disease. Next, during the time he was at the Scripps Research Institute, along with colleagues such as pathologist Dr. Kelly Bethel, Kuhn showed that cells found in the circulatory system resemble those in the primary tumor from an anatomical pathology point of view (1). Finally, Mehmet Toner, professor of surgery at the Massachusetts General Hospital, and colleagues established that when changes in the circulatory system were monitored, one could detect the emergence of drug resistance. Which brings us to today, and Dr. Kuhn's latest work. Kuhn uses the phrase “no cell left behind” when describing his approach toward CTC detection and characterization. The …