Circulating Tumour Cells (CTCs) in NSCLC: From Prognosis to Therapy Design

Abstract

Designing optimal (neo)adjuvant therapy is a crucial aspect of the treatment of non-small-cell lung carcinoma (NSCLC). Standard methods of chemotherapy, radiotherapy, and immunotherapy represent effective strategies for treatment. However, in some cases with high metastatic activity and high levels of circulating tumour cells (CTCs), the efficacy of standard treatment methods is insufficient and results in treatment failure and reduced patient survival. CTCs are seen not only as an isolated phenomenon but also a key inherent part of the formation of metastasis and a key factor in cancer death. This review discusses the impact of NSCLC therapy strategies based on a meta-analysis of clinical studies. In addition, possible therapeutic strategies for repression when standard methods fail, such as the administration of low-toxicity natural anticancer agents targeting these phenomena (curcumin and flavonoids), are also discussed. These strategies are presented in the context of key mechanisms of tumour biology with a strong influence on CTC spread and metastasis (mechanisms related to tumour-associated and -infiltrating cells, epithelial–mesenchymal transition, and migration of cancer cells).

Anti-breast cancer effects of phytochemicals: primary, secondary, and tertiary care

“…For the stratified patients, flavonoids per evidence are of great clinical utility as an effective sensitizer for anti-cancer therapy [ 125 ]. Finally, patients stratified as being highly predisposed to metastatic BC might strongly benefit from the administration of low-toxicity natural anticancer agents targeting specifically CTCs [ 126 ].…”

The Role of IL-6 in Cancer Cell Invasiveness and Metastasis—Overview and Therapeutic Opportunities

“…Similarly, simultaneous activation of NF-κB and HIF-1α can synergically enhance tumour development and metastasis formation [ 119 ]. Nevertheless, their effects could be strongly suppressed by the co-application of low-toxic, multi-targeting natural compounds such as curcuminoids and flavonoids with potent anti-metastatic effects [ 124 ]. For example, curcumin is a direct inhibitor of NF-κB signalling, and its application can also repress the hypoxic phenotype by targeting HSP90 and mTOR (HIF-1α stabilisation and expression) [ 84 , 125 , 126 ].…”

Ginseng-derived nanoparticles inhibit lung cancer cell epithelial mesenchymal transition by repressing pentose phosphate pathway activity

“…Lung cancer, a life-threatening oncological disease, is the leading cause of cancer-related deaths worldwide. It is well known that the majority of oncologic-related deaths are not caused by primary tumors but are instead caused by metastatic tumors ( 32 , 33 ). The core process that is generally thought to drive tumor metastasis is the epithelial-mesenchymal transition (EMT), a process by which cells lose epithelial characteristics associated with low metastatic potential and gain mesenchymal cell characteristics associated with high metastatic potential ( 34 ).…”