Circulating Tumor Cells: Beyond Isolation and Detection

Michelle J. McNamara*

Circulating Tumor Cells: Beyond Isolation and Detection.

Although the current clinical utility has been focused on the prognostic significance,
other clinical applications are being explored, such as determining if a patient is a
candidate for treatment, determining the efficacy of treatment,
evaluation for resistance to therapy, prediction of metastatic site,
or as an early predictor of metastases. Current methodologies are based on quantifying CTCs and include technologies based on physical, immunological, and molecular techniques.

Evaluation of CTCs should incorporate histological, immunehistochemical, and molecular characterization to enable clinicians to obtain the comprehensive diagnostic,
prognostic and therapeutic information necessary to provide appropriate personalized care to cancer patients.

Cancer is the second leading cause of death in the United States, and most cancer-related deaths are a result of metastatic disease. Thousands of circulating tumor cells are shed by tumors daily and are the means by which these cancers metastasize.

There has been emerging evidence that the presence of CTCs in the peripheral circulation correlates with decreased progression-free and overall survival in many cancers.Although the 5 year-survival rate for most types of metastatic cancer is fairly dismal, the complexity of the metastatic process makes it difficult to completely understand their prognostic significance.

Additionally, their clinical relevance is not limited to their metastatic potential and their prognostic impact, and their assessment can possibly be expanded to other applications with development of improved isolation and detection technologies.

Furthermore, studies being conducted on other tumor types, including lung, prostate, and colorectal cancer, have yielded similar results, however, research is still ongoing to completely characterize the presence of CTCs and its relationship to disease progression.

Pathol Lab Med Open J. 2019; 1(1): 45-53. doi: 10.17140/PLMOJ-1-108