title: Do circulating tumor cells, exosomes, and circulating tumor nucleic acids have clinical utility? A report of the association for molecular pathology.
abstract: Diagnosing and screening for tumors through noninvasive means represent an important paradigm shift in precision medicine. In contrast to tissue biopsy, detection of circulating tumor cells (CTCs) and circulating tumor nucleic acids provides a minimally invasive method for predictive and prognostic marker detection. This allows early and serial assessment of metastatic disease, including follow-up during remission, characterization of treatment effects, and clonal evolution. Isolation and characterization of CTCs and circulating tumor DNA (ctDNA) are likely to improve cancer diagnosis, treatment, and minimal residual disease monitoring. However, more trials are required to validate the clinical utility of precise molecular markers for a variety of tumor types. This review focuses on the clinical utility of CTCs and ctDNA testing in patients with solid tumors, including somatic and epigenetic alterations that can be detected. A comparison of methods used to isolate and detect CTCs and some of the intricacies of the characterization of the ctDNA are also provided.
authors.affiliation: Circulating Tumor Cells Working Group of the Clinical Practice Committee, Association for Molecular Pathology, Bethesda, Maryland; Center for Cancer Research, National Cancer Institute, Frederick, Maryland. Electronic address: bert.gold@nih.gov.
authors.forename: Bert
authors.initials: B
authors.lastname: Gold
authors.affiliation: Circulating Tumor Cells Working Group of the Clinical Practice Committee, Association for Molecular Pathology, Bethesda, Maryland; Department of Pathology, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Milena
authors.initials: M
authors.lastname: Cankovic
authors.affiliation: Circulating Tumor Cells Working Group of the Clinical Practice Committee, Association for Molecular Pathology, Bethesda, Maryland; Department of Pathology, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Larissa V
authors.initials: LV
authors.lastname: Furtado
authors.affiliation: Circulating Tumor Cells Working Group of the Clinical Practice Committee, Association for Molecular Pathology, Bethesda, Maryland; Department of Pathology, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Frederick
authors.initials: F
authors.lastname: Meier
authors.affiliation: Circulating Tumor Cells Working Group of the Clinical Practice Committee, Association for Molecular Pathology, Bethesda, Maryland; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Gocke
mesh_terms: D000818:Animals; D014408:Biomarkers, Tumor / Q000097:blood / Q000235:genetics; D004273:DNA, Neoplasm / Q000097:blood* / Q000235:genetics; D044127:Epigenesis, Genetic; D055354:Exosomes / Q000473:pathology*; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D009154:Mutation; D009369:Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D057089:Pathology, Molecular; D012334:RNA, Neoplasm / Q000097:blood* / Q000235:genetics
chemical_list: D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D012334:RNA, Neoplasm