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May CTC technologies promote better cancer management?

Pesta M, Kulda V, Narsanska A, Fichtl J, Topolcan O - EPMA J (2015)

Bottom Line: Despite promising results, the decisions on stage of disease and how to guide the adjuvant treatment still do not include results of CTC assessment.The first reason arises from the biological nature of the tumor itself and the second reason is associated with an interdisciplinary status of CTC diagnostics in the sense that it is neither a theme purely for pathologists nor for haemato-oncologists nor clinical biochemists.The second is a molecular characterization of captured CTCs for targeted treatment, and the third is a cultivation of captured CTCs for drug sensitivity testing.

View Article: PubMed Central - PubMed

Affiliation: Department of Biology, The Faculty of Medicine in Pilsen, Charles University in Prague, Karlovarska 48, 301 66 Pilsen, Czech Republic ; Biomedical Center, The Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic.

ABSTRACT
In the case of cancer, death is usually not due to the primary tumor itself but due to dissemination. Analysis of the circulating tumor cells (CTCs), i.e., cells responsible for a formation of metastases, should provide information useful for the management of cancer patients, fulfilling the objectives of predictive, preventive, and personalized medicine (PPPM). Despite promising results, the decisions on stage of disease and how to guide the adjuvant treatment still do not include results of CTC assessment. We want to describe two major reasons why the recent diagnostic value of CTC analysis is not sufficient for clinical use. The first reason arises from the biological nature of the tumor itself and the second reason is associated with an interdisciplinary status of CTC diagnostics in the sense that it is neither a theme purely for pathologists nor for haemato-oncologists nor clinical biochemists. We anticipate that there are at least three areas where CTCs can be useful for clinical practice. The first is monitoring of treatment efficacy of cancer patients. The second is a molecular characterization of captured CTCs for targeted treatment, and the third is a cultivation of captured CTCs for drug sensitivity testing. All of these approaches allow researchers recognize and respond to changes of phenotype of cancer cells during disease progression and introduce PPPM into clinical practice.

No MeSH data available.


Related in: MedlinePlus

CTC count in different metastatic cancer types; data adapted from [18]. The plot compares CTC counts enumerated by CellSearch system (the number of CTCs in 7.5 ml of whole blood) from healthy donors (normals) and patients with nonmalignant diseases (benigns) with CTC counts from patients with metastatic prostate, breast, lung, ovarian, colorectal, pancreatic, and other cancers.
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Fig1: CTC count in different metastatic cancer types; data adapted from [18]. The plot compares CTC counts enumerated by CellSearch system (the number of CTCs in 7.5 ml of whole blood) from healthy donors (normals) and patients with nonmalignant diseases (benigns) with CTC counts from patients with metastatic prostate, breast, lung, ovarian, colorectal, pancreatic, and other cancers.

Mentions: A CTC is identified by many methods as a nucleated cell that is positive for EpCAM, is cytokeratin positive, and is CD45 negative. This strategy targets tumor cells in peripheral blood as cells having a nonhematopoetic phenotype with epithelial characteristics. On the basis of this CTC definition, a lot of successful work has been done. For example, it was found that the amount of CTCs differs in various types of tumors, as was shown in the work of Allard et al., Figure 1, [18]. In some groups of patients, it was found that the number of CTCs detected is related to prognosis [19–21]. The simplest approach, enumeration, is based on the number of detected CTCs. The result (the number of detected CTCs) strongly depends on detection technique. It is necessary to mention that this approach passes other properties and processes which are to current knowledge associated with malignant potential as EMT or cohesive and collective cell migration.Figure 1


May CTC technologies promote better cancer management?

Pesta M, Kulda V, Narsanska A, Fichtl J, Topolcan O - EPMA J (2015)

CTC count in different metastatic cancer types; data adapted from [18]. The plot compares CTC counts enumerated by CellSearch system (the number of CTCs in 7.5 ml of whole blood) from healthy donors (normals) and patients with nonmalignant diseases (benigns) with CTC counts from patients with metastatic prostate, breast, lung, ovarian, colorectal, pancreatic, and other cancers.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4307224&req=5

Fig1: CTC count in different metastatic cancer types; data adapted from [18]. The plot compares CTC counts enumerated by CellSearch system (the number of CTCs in 7.5 ml of whole blood) from healthy donors (normals) and patients with nonmalignant diseases (benigns) with CTC counts from patients with metastatic prostate, breast, lung, ovarian, colorectal, pancreatic, and other cancers.
Mentions: A CTC is identified by many methods as a nucleated cell that is positive for EpCAM, is cytokeratin positive, and is CD45 negative. This strategy targets tumor cells in peripheral blood as cells having a nonhematopoetic phenotype with epithelial characteristics. On the basis of this CTC definition, a lot of successful work has been done. For example, it was found that the amount of CTCs differs in various types of tumors, as was shown in the work of Allard et al., Figure 1, [18]. In some groups of patients, it was found that the number of CTCs detected is related to prognosis [19–21]. The simplest approach, enumeration, is based on the number of detected CTCs. The result (the number of detected CTCs) strongly depends on detection technique. It is necessary to mention that this approach passes other properties and processes which are to current knowledge associated with malignant potential as EMT or cohesive and collective cell migration.Figure 1

Bottom Line: Despite promising results, the decisions on stage of disease and how to guide the adjuvant treatment still do not include results of CTC assessment.The first reason arises from the biological nature of the tumor itself and the second reason is associated with an interdisciplinary status of CTC diagnostics in the sense that it is neither a theme purely for pathologists nor for haemato-oncologists nor clinical biochemists.The second is a molecular characterization of captured CTCs for targeted treatment, and the third is a cultivation of captured CTCs for drug sensitivity testing.

View Article: PubMed Central - PubMed

Affiliation: Department of Biology, The Faculty of Medicine in Pilsen, Charles University in Prague, Karlovarska 48, 301 66 Pilsen, Czech Republic ; Biomedical Center, The Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic.

ABSTRACT
In the case of cancer, death is usually not due to the primary tumor itself but due to dissemination. Analysis of the circulating tumor cells (CTCs), i.e., cells responsible for a formation of metastases, should provide information useful for the management of cancer patients, fulfilling the objectives of predictive, preventive, and personalized medicine (PPPM). Despite promising results, the decisions on stage of disease and how to guide the adjuvant treatment still do not include results of CTC assessment. We want to describe two major reasons why the recent diagnostic value of CTC analysis is not sufficient for clinical use. The first reason arises from the biological nature of the tumor itself and the second reason is associated with an interdisciplinary status of CTC diagnostics in the sense that it is neither a theme purely for pathologists nor for haemato-oncologists nor clinical biochemists. We anticipate that there are at least three areas where CTCs can be useful for clinical practice. The first is monitoring of treatment efficacy of cancer patients. The second is a molecular characterization of captured CTCs for targeted treatment, and the third is a cultivation of captured CTCs for drug sensitivity testing. All of these approaches allow researchers recognize and respond to changes of phenotype of cancer cells during disease progression and introduce PPPM into clinical practice.

No MeSH data available.


Related in: MedlinePlus