Circulating tumor cells as prognostic biomarkers in breast cancer: current status and future prospects

ABSTRACT

Introduction : Despite advances in diagnostic and therapeutic techniques breast cancer is still associated with significant morbidity and mortality. CTCs play a crucial role in the metastatic process, which is the main cause of death in BC patients.

Areas covered : This review discusses the prognostic and predictive value of CTCs and their prospective in management of BC patients.

Expert opinion : The analysis of CTCs through improved technologies offers a new insight into the metastatic cascade. Assessment of the number and molecular profile of CTCs holds great promises for disease monitoring and therapeutic decisions. However, more research is needed until they can be used in therapeutic decisions in clinical practice.

KEYWORDS:

• Breast cancer
• biomarkers
• circulating tumor cells
• metastatic cascade
• prognosis

Article highlights

• Detection of CTCs at the time of BC diagnosis is a significant prognostic factor for reduced survival.

• Minimal residual disease in the form of disseminating CTCs could persist after chemotherapy and may represent a potential source of subsequent metastatic relapse.

• The detection of ≥5 CTCs/7.5 ml blood using the CellSearch platform in metastatic breast cancer (MBC) patients is associated with decreased PFS and OS.

• Given that CTC detection has a detrimental impact on clinical outcome and their CTC count changes in course of treatment seem to reflect therapy response,

• CTCs are composed of cancer cells from several different metastatic lesions and reflect the molecular landscape of the tumor more accurately.

• CTCs count is an independent prognostic factor in both EBC and MBC, but its role as a tool for monitor therapy response and treatment decisions remains uncertain.

Acknowledgments

Special thanks are given to Ms Vasso Athanasaki for her scientific secretary assistance.

Declaration of interest

The author(s) have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.