Abstract
Shedding of cancer cells from the primary site or undetectable bone marrow region into the circulatory system, resulting in clinically overt metastasis or dissemination, is the hallmark of unfavorable invasive cancers. The shed cells remain in circulation until they extravasate to form a secondary metastatic lesion or undergo anoikis. The circulating tumor cells (CTCs) found as single cells or clusters carry a plethora of information, are acknowledged as potential biomarkers for predicting cancer prognosis and cancer progression, and are supposed to play key roles in determining tailored therapies for advanced diseases. With the advent of novel technologies that allow the precise isolation of CTCs, more and more clinical trials are focusing on the prognostic and predictive potential of CTCs. In this review, we summarize the role of CTCs as a predictive marker for cancer incidence, relapse, and response to therapy.
Highlights
Tissue biopsy is the gold standard for cancer diagnosis and profiling [1]; determining a treatment regimen for advanced diseases based solely on the information available from tissue biopsies is challenging [2]
The clinical validity of Circulating tumor cells (CTCs) enumeration was supported by a series of multicenter studies which led to the inclusion of CTCs for cancer staging for breast cancer (BC) patients by the 8th edition of the American Joint Committee on Cancer (AJCC) cancer staging manual and in the World Health Organization’s WHO
The relevance and promise of CTC screening and analysis in predicting cancer progression and response to therapy are implicated in several studies
Summary
Tissue biopsy is the gold standard for cancer diagnosis and profiling [1]; determining a treatment regimen for advanced diseases based solely on the information available from tissue biopsies is challenging [2]. Circulating tumor cells (CTCs) were first identified almost a century ago by the Australian physician Thomas Ashworth in the blood of metastatic cancer patients [3]. It was not until the past two decades that their prognostic potential was elucidated, primarily because of the significant technical challenges in isolating these rare cells from an overwhelming background of peripheral blood mononuclear cells (PBMCs). Liquid biopsy (LBx) refers to isolating cancer cells or cancer cell-derived components from body fluids for further analysis [4] This approach is gaining significant attention due to its noninvasive nature and minimal risk associated with longitudinal sampling [5,6]. Pharmaceuticals 2022, 15, 75 and specificity [9], the bottleneck in the CTC research field has shifted from their efficient isolation to their molecular analysis and demonstration of their clinical utility as potential prognostic, predictive, and pharmacodynamic biomarkers
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