Department of Medical Oncology, Comenius University, School of Medicine, Klenova 1, Bratislava 833 10, Slovakia.
Nat Rev Clin Oncol. 2010 Dec;7(12):693-701. doi: 10.1038/nrclinonc.2010.171. Epub 2010 Oct 19.
The metastatic cascade is a series of biological processes that enable the movement of tumor cells from the primary site to a distant location and the establishment of a new cancer growth. Circulating tumor cells (CTCs) have a crucial role in tumor dissemination. The role of CTCs in treatment failure and disease progression can be explained by their relation to biological processes, including the epithelial-to-mesenchymal transition and 'self seeding', defined as reinfiltration of the primary tumor or established metastasis by more aggressive CTCs. CTCs are a unique and heterogeneous cell population with established prognostic and predictive value in certain clinical situations. The possibility of collecting sequential blood samples for real-time monitoring of systemic-therapy efficacy presents new possibilities to evaluate targeted therapies based on the genomic profiling of CTCs and to improve the clinical management of patients by personalized therapy. Interruption of the metastatic cascade via the targeting of CTCs might be a promising therapeutic strategy.
转移级联是一系列生物学过程，使肿瘤细胞能够从原发部位转移到远处并建立新的癌症生长。循环肿瘤细胞（CTC）在肿瘤播散中起关键作用。CTC 在治疗失败和疾病进展中的作用可以通过它们与生物学过程的关系来解释，包括上皮-间充质转化和“自我播种”，定义为更具侵袭性的 CTC 重新浸润原发性肿瘤或已建立的转移灶。CTC 是一种独特的异质性细胞群体，在某些临床情况下具有明确的预后和预测价值。通过实时监测系统治疗效果，连续采集血液样本的可能性为基于 CTC 基因组分析的靶向治疗提供了新的可能性，并通过个性化治疗改善患者的临床管理。通过靶向 CTC 阻断转移级联可能是一种有前途的治疗策略。
