Circulating tumor cells isolation: the "post-EpCAM era".

Area of Science:

• Oncology
• Cell Biology
• Cancer Diagnostics

Background:

• Circulating tumor cells (CTCs) are shed from primary tumors and indicate metastatic spread.
• The prognostic value of CTCs in metastatic cancer has been established for over a decade.
• CTCs exhibit significant heterogeneity and dynamic phenotypic changes.

Purpose of the Study:

• To critically analyze the limitations of epithelial cell adhesion molecule (EpCAM) as a universal marker for CTC detection.
• To discuss the pleiotropic functions of EpCAM in the context of CTC biology.
• To highlight the need for alternative methods for CTC detection that capture a wider spectrum of phenotypes.

Main Methods:

• Literature review focusing on the biology and detection of CTCs.
• Critical dissection of the role of EpCAM in CTCs.
• Analysis of CTC heterogeneity and phenotypic plasticity.

Main Results:

• The inadequacy of EpCAM as a sole marker for CTC detection is evident due to CTC heterogeneity.
• EpCAM exhibits diverse functions that influence CTC behavior and detection.
• Current detection methods relying solely on EpCAM may miss crucial CTC subpopulations.

Conclusions:

• Alternative strategies beyond EpCAM are essential for comprehensive CTC detection.
• Understanding EpCAM's multifaceted roles is key to improving CTC-based diagnostics.
• Developing novel assays is crucial to capture the full spectrum of CTC phenotypes for accurate cancer prognostication.