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CIRCULATING TUMOR CELLS IN CANCER PROGNOSIS AND PREDICTION

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: Taiwan : 台北市115南港區園區街3號18樓之一 USA : 1271 Oakmead Parkway Sunnyvale, CA 94085

Circulating Tumor Cells: A Review

Research into the cellular, genetic and molecular basis of cancer holds great promise for advancing personalized diagnostics and therapeutics. In particular, the characterization and quantification of circulating tumor cells (CTCs) has been demonstrated to be valuable in the management of cancer.1,2,3 CTCs are shed into the bloodstream by in situ neoplasms. CTCs are the mechanism by which cancer metastasizes to distant sites in the body, and thus tracking them has the potential to radically alter patient treatment and outcome.4 Several areas have been suggested as being of interest to advancing cancer care using CTCs: using CTCs for early detection of potential metastasis, determining and monitoring the efficacy of individualized treatment regimens, and predicting site-specific metastasis.5 Today, many efforts continue to define, detect, isolate, and enumerate CTCs in peripheral blood. Identifying these rare cells in the blood can help detect early tumor dissemination & metastasis. However, isolating CTCs in the early stages of cancer, or in precancerous lesions, has been a particularly difficult challenge.6,7,8

Several recent clinical studies, including at least one 3000-patient meta-analysis, confirm that CTC detection is highly correlated with poor cancer prognosis. Early detection of recurrence has been shown to significantly improve overall survival9. Studies show that patients with asymptomatic recurrence (over symptomatic recurrence) have better overall prognosis.10,11 CTCs are present the blood at early stages of cancer inception and recurrence and have been shown to disseminate systemically from ductal carcinoma in situ in women and in premalignant stages of pancreatic cancer tumor progression12,13,14. Studies have demonstrated CTCs can play an important role as an adjunct to imaging demonstrating that rising CTC levels can occur before imaging is able to detect a possible change in patient status.15

Identifying, isolating and enumerating CTCs in peripheral blood of patients is an important new tool to in cancer prevention and management. The CellMax Life® tests provide physicians an additional marker to guide their clinical judgement with regard to both healthy individuals and colorectal cancer patients and are a vital tool in better identification, prevention and management of cancer.16

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REFERENCES

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: Taiwan : 台北市115南港區園區街3號18樓之一 USA : 1271 Oakmead Parkway Sunnyvale, CA 94085

1. Hao-Wei Teng, et al. “A new classification scheme for recurrent ormetastatic colon cancer after liver metastasectomy”. JCMA 74, p.493, 20112. Stewart BW, Wild CP, (Ed.). World Cancer Report 2014. InternationalAgency for Research on Cancer, Lyon, France, 2014.3. Chen et al, Int J Colorectal Dis. 2010 May;25(5):567-71.4. Patterns of recurrence after curative resection of carcinoma of the colonand rectum. Wolff BG, Surg Gynecol Obstet. 1992 Jan; 174(1):27-32.5. Millner et al. Circulating tumor cells: a review of present methods and theneed to identify heterogeneous phenotypes. Ann Clin Lab Sci. 2013 Summer;43(3):295-304.6. Nesteruk, et al. "Evaluation of Prognostic Significance of Circulating TumorCells Detection in Rectal Cancer Patients Treated with Preoperative Radiotherapy: Prospectively Collected Material Data." BioMed Research International, vol. 2014, Article ID 712827, 6 pages, 2014. 7. Shen et al, "Detection of circulating tumor cells: Clinical relevance of anovel metastatic tumor marker," Exp. Ther. Med; Volume 2 Issue 3; May 20118. Public domain image, National Cancer Institute, USA9. Rahbari et al. "Meta-analysis Shows That Detection of Circulating TumorCells Indicates Poor Prognosis in Patients With Colorectal Cancer." Gastroenterology 2010;138:1714–172610. Marchetti et al. "Circulating Tumor Cells Count Predicts Survival inColorectal Cancer Patients." J Gastrointestin Liver Dis, September 2014 Vol. 23 No 3: 279-284 201411. Cohen SJ, Punt CJ, Iannotti N, et al: Relationship of circulating tumor cellsto tumor response, progression-free survival, and overall survival in patients with metastatic colorectal cancer. J Clin Oncol 2008 Jul;26(19):3212-322112. Klein, et al. “Systemic spread is an early step in breast cancer,” CancerCell. 2008 Jan;13(1):586813. Yang et al. Epithelial–mesenchymal plasticity in carcinoma metastasis.Genes & Dev. 2013. 27: 2192-220614. Cristofanilli M, Budd GT, Ellis MJ, et al: Circulating tumor cells, diseaseprogression, and survival in metastatic breast cancer. N Engl J Med 2004;351:781-79115. deBono JS, Scher HI, Montgomery RB, et al: Circulating tumor cellspredict survival benefit from treatment in the metastatic castration-resistant prostate cancer. Clin Cancer Res 2008 October 1;14(19):6302-630916. Budd TG, Cristofanilli M, Ellis MJ, et al: Circulating Tumor Cells versusImaging—Predicting Overall Survival in Metastatic Breast Cancer. Clin Cancer Res 2006 12:6403-6409

Circulating Tumor Cells: A Review