Metastasis is a biologically complex process consisting of numerous stochastic events which may tremendously differ across various cancer types. Circulating tumor cells (CTCs) are cells that are shed from primary tumors and metastatic deposits into the blood stream. CTCs bear a tremendous potential to improve our understanding of steps involved in the metastatic cascade, starting from intravasation of tumor cells into the circulation until the formation of clinically detectable metastasis. These efforts were propelled by novel high-resolution approaches to dissect the genomes and transcriptomes of CTCs. Furthermore, capturing of viable CTCs has paved the way for innovative culturing technologies to study fundamental characteristics of CTCs such as invasiveness, their kinetics and responses to selection barriers, such as given therapies. Hence the study of CTCs is not only instrumental as a basic research tool, but also allows the serial monitoring of tumor genotypes and may therefore provide predictive and prognostic biomarkers for clinicians. Here, we review how CTCs have contributed to significant insights into the metastatic process and how they may be utilized in clinical practice.
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This work was supported in the laboratory of MRS by the Austrian Science Fund (FWF) (grant#: P20338 and P23284), the Oesterreichische Nationalbank (project#: 15093) and in the laboratory of KP by the ERC Advanced Investigator Grant DISSECT, TRANSCAN ERA-Network:Grant CTC-SCAN and Deutsche Forschungsgemeinschaft (DFG) grant PA 341/19. Both authors are supported by Cancer-ID, a project funded by the Innovative Medicines Joint Undertaking (IMI JU).
The authors declare no conflict of interest.
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Pantel, K., Speicher, M. The biology of circulating tumor cells. Oncogene 35, 1216–1224 (2016). https://doi.org/10.1038/onc.2015.192
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