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Circulating tumor cells: a multifunctional biomarker.

Timothy A Yap1, David Lorente1, Aurelius Omlin2

  • 1Authors' Affiliations: Division of Clinical Studies, The Institute of Cancer Research; Drug Development Unit, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom; Kantonsspital St. Gallen, Department of Medical Oncology, Gallen, Switzerland; and Spanish National Cancer Research Centre, Madrid, SpainAuthors' Affiliations: Division of Clinical Studies, The Institute of Cancer Research; Drug Development Unit, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom; Kantonsspital St. Gallen, Department of Medical Oncology, Gallen, Switzerland; and Spanish National Cancer Research Centre, Madrid, Spain.

Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
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PubMed
Summary
This summary is machine-generated.

Circulating tumor cells (CTCs) show promise as biomarkers in cancer medicine. Challenges remain in their clinical use, but advancements offer future potential for precision therapies.

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Area of Science:

  • Translational Cancer Medicine
  • Biomarker Development
  • Oncology

Background:

  • Circulating tumor cells (CTCs) are key in metastatic spread and serve as minimally invasive biomarkers.
  • Modern CTC technologies allow serial monitoring for pharmacodynamic, prognostic, and predictive studies.
  • Despite their potential, challenges hinder routine clinical integration of CTC analysis.

Purpose of the Study:

  • To review technical aspects and challenges of CTC technologies.
  • To compare CTC enrichment platforms and discuss their utility as multifunctional biomarkers.
  • To explore CTCs as pharmacodynamic endpoints and propose strategies for their use in clinical trials.

Main Methods:

  • Review of current CTC technologies and enrichment platforms.
  • Discussion of assay validation, clinical qualification, and intrapatient heterogeneity.
  • Analysis of challenges in isolating specific CTC subtypes (e.g., EMT, apoptotic, small CTCs).

Main Results:

  • CTCs offer potential as pharmacodynamic (PD) endpoints through enumeration or molecular characterization.
  • Strategies like the Pharmacological Audit Trail can integrate CTCs into clinical trials.
  • Isolation of challenging CTC subtypes and heterogeneity remain significant hurdles.

Conclusions:

  • CTCs hold significant promise for monitoring precision therapies and guiding cancer treatment.
  • Future applications include single CTC profiling and CTC-derived xenografts.
  • Overcoming technical and biological challenges is crucial for realizing the full clinical potential of CTCs.