Clinical Significance of Circulating Tumor Cells in Gastrointestinal Carcinomas

Abstract

The idea of a liquid biopsy to screen, surveil and treat cancer patients is an intensively discussed and highly awaited tool in the field of oncology. Despite intensive research in this field, the clinical application has not been implemented yet and further research has to be conducted. However, one component of the liquid biopsy is circulating tumor cells (CTCs) whose potential for clinical application is evaluated in the following. CTCs can shed from primary tumors to the peripheral blood at any time point during the progress of a malignant disease. Following, one single CTC can be the origin for distant metastasis at later cancer stage. Thus, CTCs have great potential to either be used in cancer diagnostics and patient stratification or to function as a target for new therapeutic approaches to stop tumor dissemination and metastasis at the very early beginning. Due to the biological fundamental role of CTCs in tumor progression, here, we provide an overview of CTCs in gastrointestinal cancers and their potential use in the clinical setting. In particular, we discuss the usage of CTC for screening and stratifying patients’ risk. Moreover, we will discuss the potential role of CTCs for treatment specification and treatment monitoring.

Resectable Colorectal Cancer: Current Perceptions on the Correlation of Recurrence Risk, Microbiota and Detection of Genetic Mutations in Liquid Biopsies

“…Their clinical applications are still limited. They have been studied in CRC treatment monitoring—while other studies have assessed their potential in the diagnosis of gastric, esophageal or pancreatic cancer [ 83 ]. The most recent study, including 56 CRC patients, suggested that mutations not detected in primary tumors can be identified in CTCs’ DNA, highlighting their potential in complementing gene analysis.…”

Discriminating Epithelial to Mesenchymal Transition Phenotypes in Circulating Tumor Cells Isolated from Advanced Gastrointestinal Cancer Patients

“…As such, their identification, enumeration and molecular characterization can provide valuable information. CTCs have been proposed to be used as an easy screening tool to facilitate early diagnosis of malignant diseases [8]. Moreover, CTC detection in solid tumors can improve the accuracy of prognosis, extend the risk stratification for patient with occult micrometastases and help to provide the best individual therapy to every patient [8].…”

“…CTCs have been proposed to be used as an easy screening tool to facilitate early diagnosis of malignant diseases [8]. Moreover, CTC detection in solid tumors can improve the accuracy of prognosis, extend the risk stratification for patient with occult micrometastases and help to provide the best individual therapy to every patient [8]. Downstream analysis of CTCs from each cancer patient will allow the identification of therapeutic targets to guide patient treatment and to monitor molecular evolution of the disease, ultimately allowing the study of cell clonality and the discovery of new biomarkers [8,9].…”

Detection and clinical significance of circulating tumor cells in colorectal cancer

“…Studies of different cohorts have shown that the quantity of CTCs is valuable for assessing the prognosis of CRC [ 13 , 14 ]. CTCs also show application value in early diagnosis and monitoring the dynamic changes [ 15 , 16 ].…”