Detection and Clinical Implications of Circulating Tumor Cells in Cancer Patients



September 12, 2013

Microscopic spread of cancer cells is usually undetected by current imaging technologies. Therefore, a variety of sensitive methods have been developed to detect circulating tumor cells (CTC) in the peripheral blood. The capture of CTC that are surrounded by millions of blood cells is based on the physical and/or biological properties of cancer cells. Thus far, only the automated CellSearchTM system has been cleared by the FDA. However, many assays including the CellSearchTM system rely on EpCAM for CTC capture and cytokeratins for CTC detection but these epithelial marker proteins can be downregulated during epithelial-mesenchymal transition. Besides assessing the clinical utility of CTC for assessment of prognosis, monitoring of CTC during and after systemic therapy can provide unique information for the clinical management of individual cancer patients. In particular, the molecular analysis of CTC as “liquid biopsy” will give new insights into therapeutic targets and the selection of tumor cells under specific therapies. In addition, molecular and functional characterization of CTC opens a new avenue for understanding metastatic spread of tumor cells with important implications for future therapies. Implementation of CTC analyses in clinical trials testing new anti-cancer agents as companion diagnostics will speed up the cumbersome and expensive drug validation process in oncology.

BioengineeringMolecular BiologyStem Cells

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