Circulating tumour cells in breast cancer: Prognostic indicators, metastatic intermediates, or irrelevant bystanders? (Review)

Hogan, Brian; Peter, Mark; Shenoy, Hrishikesh; Horgan, Kieran; Hughes, Tom

doi:10.3892/mmr_00000027

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…Circulating tumor cell (CTC) detection requires highly sensitive techniques . Baseline CTC number and treatment‐induced alterations are associated with progression free (PFS) and OS in metastatic disease . In early‐stage breast cancer, CTCs are associated with lymph node involvement and DFS …”

Section: Emerging Single Biomarkersmentioning

confidence: 99%

Biomarkers for the clinical management of breast cancer: International perspective

Patani

Martin

Dowsett

2013

Intl Journal of Cancer

158

113

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The higher incidence of breast cancer in developed countries has been tempered by reductions in mortality, largely attributable to mammographic screening programmes and advances in adjuvant therapy. Optimal systemic management requires consideration of clinical, pathological and biological parameters. Oestrogen receptor alpha (ERa), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2) are established biomarkers evaluated at diagnosis, which identify cardinal subtypes of breast cancer. Their prognostic and predictive utility effectively guides systemic treatment with endocrine, anti-HER2 and chemotherapy. Hence, accurate and reliable determination remains of paramount importance. However, the goals of personalized medicine and targeted therapies demand further information regarding residual risk and potential benefit of additional treatments in specific circumstances. The need for biomarkers which are fit for purpose, and the demands placed upon them, is therefore expected to increase. Technological advances, in particular high-throughput global gene expression profiling, have generated multi-gene signatures providing further prognostic and predictive information. The rational integration of routinely evaluated clinico-pathological parameters with key indicators of biological activity, such as proliferation markers, also provides a ready opportunity to improve the information available to guide systemic therapy decisions. The additional value of such information and its proper place in patient management is currently under evaluation in prospective clinical trials. Expanding the utility of biomarkers to lower resource settings requires an emphasis on cost effectiveness, quality assurance and possible international variations in tumor biology; the potential for improved clinical outcomes should be justified against logistical and economic considerations.

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Section: Emerging Single Biomarkersmentioning

confidence: 99%

Biomarkers for the clinical management of breast cancer: International perspective

Patani

Martin

Dowsett

2013

Intl Journal of Cancer

158

113

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“…The counts for all controls (healthy subjects and patients with other lung diseases) were under the designated limit. In such cases, detection of CTCs is most likely a false positive result due to the extremely large numbers of blood cells in the samples [21,22]. On the other hand, Illie et al found that CTC-positive patients with tobacco-induced chronic obstructive pulmonary disease may have developed lung cancer [23].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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).

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“…It is also known that not every CTC will result in a new metastatic lesion. The pool of CTCs is composed of live and actively metastasizing cells and bystanders that are passively shed into the circulation [5], [13]–[15], in combination with apoptotic tumor cell debris [16]–[18]. Alternative CTC detection strategies are needed, to isolate the metastasizing fraction, which is most likely to be found in the live CTC pool.…”

Section: Introductionmentioning

confidence: 99%

Detection of Live Circulating Tumor Cells by a Class of Near-Infrared Heptamethine Carbocyanine Dyes in Patients with Localized and Metastatic Prostate Cancer

Shao

Liao

et al. 2014

PLoS ONE

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Tumor cells are inherently heterogeneous and often exhibit diminished adhesion, resulting in the shedding of tumor cells into the circulation to form circulating tumor cells (CTCs). A fraction of these are live CTCs with potential of metastatic colonization whereas others are at various stages of apoptosis making them likely to be less relevant to understanding the disease. Isolation and characterization of live CTCs may augment information yielded by standard enumeration to help physicians to more accurately establish diagnosis, choose therapy, monitor response, and provide prognosis. We previously reported on a group of near-infrared (NIR) heptamethine carbocyanine dyes that are specifically and actively transported into live cancer cells. In this study, this viable tumor cell-specific behavior was utilized to detect live CTCs in prostate cancer patients. Peripheral blood mononuclear cells (PBMCs) from 40 patients with localized prostate cancer together with 5 patients with metastatic disease were stained with IR-783, the prototype heptamethine cyanine dye. Stained cells were subjected to flow cytometric analysis to identify live (NIR+) CTCs from the pool of total CTCs, which were identified by EpCAM staining. In patients with localized tumor, live CTC counts corresponded with total CTC numbers. Higher live CTC counts were seen in patients with larger tumors and those with more aggressive pathologic features including positive margins and/or lymph node invasion. Even higher CTC numbers (live and total) were detected in patients with metastatic disease. Live CTC counts declined when patients were receiving effective treatments, and conversely the counts tended to rise at the time of disease progression. Our study demonstrates the feasibility of applying of this staining technique to identify live CTCs, creating an opportunity for further molecular interrogation of a more biologically relevant CTC population.

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Circulating tumour cells in breast cancer: Prognostic indicators, metastatic intermediates, or irrelevant bystanders? (Review)

Cited by 4 publications

References 25 publications

Biomarkers for the clinical management of breast cancer: International perspective

Biomarkers for the clinical management of breast cancer: International perspective

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

Detection of Live Circulating Tumor Cells by a Class of Near-Infrared Heptamethine Carbocyanine Dyes in Patients with Localized and Metastatic Prostate Cancer

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