Circulating Tumor Cells: What Is in It for the Patient? A Vision towards the Future

Cancers

Jaap M. J. den Toonder¹  Anja van de Stolpe² 

[1] Chair Microsystems, Eindhoven University of Technology, Postbox 513, Eindhoven 5600 MB,The Netherlands;Fellow, Precision and Decentralized Diagnostics, Philips Research, Eindhoven 5656 AE,The Netherlands;

关键词: cancer;    metastasis;    circulating tumor cell;    CTC;    digital pathology;    companion diagnostics;    cell-free DNA;    organ-on-chip;    computational pathway model;   

DOI  :  10.3390/cancers6021195

来源: DOAJ

【 摘 要 】

Knowledge on cellular signal transduction pathways as drivers of cancer growth and metastasis has fuelled development of “targeted therapy” which “targets” aberrant oncogenic signal transduction pathways. These drugs require nearly invariably companion diagnostic tests to identify the tumor-driving pathway and the cause of the abnormal pathway activity in a tumor sample, both for therapy response prediction as well asfor monitoring of therapy response and emerging secondary drug resistance. Obtaining sufficient tumor material for this analysis in the metastatic setting is a challenge, and circulating tumor cells (CTCs) may provide an attractive alternative to biopsy on the premise that they can be captured from blood and the companion diagnostic test results are correctly interpreted. We discuss novel companion diagnostic directions, including the challenges, to identify the tumor driving pathway in CTCs, which in combination witha digital pathology platform and algorithms to quantitatively interpret complex CTC diagnostic results may enable optimized therapy response prediction and monitoring. In contrast to CTC-based companion diagnostics, CTC enumeration is envisioned to be largely replaced by cell free tumor DNA measurements in blood for therapy response and recurrence monitoring. The recent emergence of novel in vitro human model systems inthe form of cancer-on-a-chip may enable elucidation of some of the so far elusive characteristics of CTCs, and is expected to contribute to more efficient CTC capture and CTC-based diagnostics.

【 授权许可】

Unknown