Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
International Research Center, A.C. Camargo Cancer Centre, São Paulo, Brazil.
Adv Exp Med Biol. 2020;1220:61-80. doi: 10.1007/978-3-030-35805-1_5.
Metastasis is the major cause of breast cancer death worldwide. In metastatic breast cancer, circulating tumor cells (CTCs) can be captured from patient blood samples sequentially over time and thereby serve as surrogates to assess the biology of surviving cancer cells that may still persist in solitary or multiple metastatic sites following treatment. CTCs may thus function as potential real-time decision-making guides for selecting appropriate therapies during the course of disease or for the development and testing of new treatments. The heterogeneous nature of CTCs warrants the use of single cell platforms to better inform our understanding of these cancer cells. Current techniques for single cell analyses and techniques for investigating interactions between cancer and immune cells are discussed. In addition, methodologies for growing patient-derived CTCs in vitro or propagating them in vivo to facilitate CTC drug testing are reviewed. We advocate the use of CTCs in appropriate microenvironments to appraise the effectiveness of cancer chemotherapies, immunotherapies, and for the development of new cancer treatments, fundamental to personalizing and improving the clinical management of metastatic breast cancer.
转移是全世界乳腺癌死亡的主要原因。在转移性乳腺癌中，循环肿瘤细胞（CTC）可以随着时间的推移从患者的血液样本中依次捕获，因此可以作为替代物来评估治疗后可能仍然存在于单一或多个转移性部位的存活癌细胞的生物学特性。CTC 因此可以作为潜在的实时决策指导，用于在疾病过程中选择适当的治疗方法，或用于开发和测试新的治疗方法。CTC 的异质性需要使用单细胞平台来更好地了解这些癌细胞。本文讨论了用于单细胞分析的当前技术以及用于研究癌症与免疫细胞之间相互作用的技术。此外，还回顾了体外培养患者来源的 CTC 或在体内繁殖它们以促进 CTC 药物测试的方法。我们提倡在适当的微环境中使用 CTC 来评估癌症化疗、免疫疗法的有效性，并开发新的癌症治疗方法，这对于个性化和改善转移性乳腺癌的临床管理至关重要。
