Progress in circulating tumor cell capture and analysis: implications for cancer management

Abstract

The hematogenous dissemination of cancer and development of distant metastases is the cause of nearly all cancer deaths. Detection of circulating tumor cells (CTCs) as a surrogate biomarker of metastases has gained increasing interest. There is accumulating evidence on development of novel technologies for CTC detection, their prognostic relevance and their use in therapeutic response monitoring. Many clinical trials in the early and metastatic cancer setting, particularly in breast cancer, are including CTCs in their translational research programs and as secondary end points. We summarize the progress of detection methods in the context of their clinical importance and speculate on the possibilities of wider implementation of CTCs as a diagnostic oncology tool, the likelihood that CTCs will be used as a useful biomarker, especially to monitor therapeutic response, and what may be expected from the future improvements in technologies.

Keywords::

• cancer stem cells
• characterization
• circulating tumor cells
• CTC
• detection
• DTC
• enrichment
• epithelial–mesenchymal transition
• metastasis

Financial & competing interests disclosure

RJ Cote, RH Datar and H Lin are among the inventors of the patented parylene microfilter technology, which has been licensed to a company Filtini Inc. (CA, USA). As inventors, they stand to gain from royalties arising out of commercialization of the technology. Also, RJ Cote owns stocks in Filtini Inc., while RH Datar serves as a scientific advisor to Filtini Inc. and has stock options. This work was supported by NCI grant CA-123027 (RJC). The authors have no other 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 apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.