Biophysical adaptations of circulating tumor cells undergoing metastasis

Circulating tumor cells (CTCs) are cancerous cells that break away from the primary tumor, enter the bloodstream, and travel to another part of the body. Research into CTCs, particularly their biological phenotypes and molecular mechanisms, has provided critical insights into metastasis and potential therapeutic targets. From a biophysical or mechanobiological perspective, CTCs must undergo biomechanical adaptations to navigate the processes of intravasation, circulation, arrest, and extravasation. These adaptations enable them to interact with blood components and survive in the circulatory system for hours or even days, ultimately facilitating metastatic progression. As research on metastasis within the bloodstream advances, this review explores the mechanobiology of CTCs, emphasizing the cellular and molecular mechanisms that regulate their suspension and adhesion states. Understanding these dynamic behaviors will offer deeper insights into CTC biology and the metastatic cascade.