Utilizing circulating tumor cells: challenges and pitfalls.
Circulating tumor cells (CTC) detected in the blood of cancer patients could be used for risk-stratification, molecular subclassification and as an intermediate end-point in therapeutic efficacy studies. Most studies to date have focused on enumeration of CTC in advanced cancer patients but further development of CTC evaluation technologies could allow expansion into early disease, monitoring of treatment response, and selection of patients for targeted therapies based on a CTC derived signature. This review discusses the challenges faced in achieving these goals, including the potential absence of CTC in patients with no blood-borne metastases, CTC intra-patient molecular heterogeneity, ex vivo loss of CTC viability, and the biological differences between CTC and metastatic tissue.
Section of Medicine, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK.
Gerhardt
G
Attard
Johann S
JS
de Bono
D014408:Biomarkers, Tumor / Q000378:metabolism; D002470:Cell Survival; D055088:Early Detection of Cancer; D018740:Genetic Heterogeneity; D006801:Humans; D009360:Neoplastic Cells, Circulating / Q000378:metabolism* / Q000473:pathology*; D011379:Prognosis
D014408:Biomarkers, Tumor