title: Opportunities and Challenges for Pancreatic Circulating Tumor Cells.
abstract: Sensitive and reproducible platforms have been developed for detection, isolation, and enrichment of circulating tumor cells (CTCs)-rare cells that enter the blood from solid tumors, including those of the breast, prostate gland, lung, pancreas, and colon. These might be used as biomarkers in diagnosis or determination of prognosis. CTCs are no longer simply detected and quantified; they are now used in ex vivo studies of anticancer agents and early detection. We review what we have recently learned about CTCs from pancreatic tumors, describing advances in their isolation and analysis and challenges to their clinical utility. We summarize technologies used to isolate CTCs from blood samples of patients with pancreatic cancer, including immunoaffinity and label-free physical attribute-based capture. We explain methods of CTC analysis and how findings from these studies might be used to detect cancer at earlier stages, monitor disease progression, and determine prognosis. We review studies that have expanded CTCs for testing of anticancer agents and how these approaches might be used to personalize treatment. Advances in the detection, isolation, and analysis of CTCs have increased our understanding of the dissemination and progression of pancreatic cancer. However, standardization of methodologies and prospective studies are needed for this emerging technology to have a significant effect on clinical care.
authors.affiliation: Department of Chemical Engineering, University of Michigan, Ann Arbor, Michigan; Biointerfaces Program, University of Michigan, Ann Arbor, Michigan; Translational Oncology Program, University of Michigan, Ann Arbor, Michigan. Electronic address: snagrath@umich.edu.
authors.forename: Sunitha
authors.initials: S
authors.lastname: Nagrath
authors.affiliation: Department of Chemical Engineering, University of Michigan, Ann Arbor, Michigan; Biointerfaces Program, University of Michigan, Ann Arbor, Michigan; Translational Oncology Program, University of Michigan, Ann Arbor, Michigan.
authors.forename: Rhonda M
authors.initials: RM
authors.lastname: Jack
authors.affiliation: Translational Oncology Program, University of Michigan, Ann Arbor, Michigan; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
authors.forename: Vaibhav
authors.initials: V
authors.lastname: Sahai
authors.affiliation: Translational Oncology Program, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan; Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan. Electronic address: simeone@med.umich.edu.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Simeone
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D006801:Humans; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor
keywords: Circulating Tumor Cells; Metastasis; Pancreatic Adenocarcinoma