Xiao Jerry, Pohlmann Paula R, Isaacs Claudine, Weinberg Benjamin A, He Aiwu R, Schlegel Richard, Agarwal Seema
Tumor Biology Training Program, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA.
Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Biomedicines. 2021 Aug 30;9(9):1111. doi: 10.3390/biomedicines9091111.
Circulating tumor cells (CTCs) are single cells or clusters of cells within the circulatory system of a cancer patient. While most CTCs will perish, a small proportion will proceed to colonize the metastatic niche. The clinical importance of CTCs was reaffirmed by the 2008 FDA approval of CellSearch, a platform that could extract EpCAM-positive, CD45-negative cells from whole blood samples. Many further studies have demonstrated the presence of CTCs to stratify patients based on overall and progression-free survival, among other clinical indices. Given their unique role in metastasis, CTCs could also offer a glimpse into the genetic drivers of metastasis. Investigation of CTCs has already led to groundbreaking discoveries such as receptor switching between primary tumors and metastatic nodules in breast cancer, which could greatly affect disease management, as well as CTC-immune cell interactions that enhance colonization. In this review, we will highlight the growing variety of isolation techniques for investigating CTCs. Next, we will provide clinically relevant context for CTCs, discussing key clinical trials involving CTCs. Finally, we will provide insight into the future of CTC studies and some questions that CTCs are primed to answer.
循环肿瘤细胞（CTCs）是癌症患者循环系统中的单个细胞或细胞簇。虽然大多数循环肿瘤细胞会死亡，但一小部分会继续在转移微环境中定植。2008年美国食品药品监督管理局（FDA）批准了CellSearch平台，该平台可从全血样本中提取上皮细胞黏附分子（EpCAM）阳性、白细胞共同抗原（CD45）阴性的细胞，这再次证实了循环肿瘤细胞的临床重要性。许多进一步的研究表明，循环肿瘤细胞的存在可根据总生存期和无进展生存期等临床指标对患者进行分层。鉴于其在转移中的独特作用，循环肿瘤细胞还可以让我们初步了解转移的基因驱动因素。对循环肿瘤细胞的研究已经带来了一些开创性的发现，比如乳腺癌原发肿瘤与转移结节之间的受体转换，这可能会极大地影响疾病管理，以及增强定植的循环肿瘤细胞与免疫细胞的相互作用。在这篇综述中，我们将重点介绍用于研究循环肿瘤细胞的越来越多的分离技术。接下来，我们将为循环肿瘤细胞提供临床相关背景，讨论涉及循环肿瘤细胞的关键临床试验。最后，我们将深入探讨循环肿瘤细胞研究的未来以及循环肿瘤细胞有望回答的一些问题。
