TY - JOUR
T1 - Circulating tumor cells : what is in It for the patient? : a vision towards the future
AU - Stolpe, van de, A.
AU - Toonder, den, J.M.J.
PY - 2014
Y1 - 2014
N2 - 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 as for 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 with a 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 in the 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.
Keywords: cancer; metastasis; circulating tumor cell; CTC; digital pathology; companion diagnostics; cell-free DNA; organ-on-chip; computational pathway model
AB - 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 as for 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 with a 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 in the 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.
Keywords: cancer; metastasis; circulating tumor cell; CTC; digital pathology; companion diagnostics; cell-free DNA; organ-on-chip; computational pathway model
U2 - 10.3390/cancers6021195
DO - 10.3390/cancers6021195
M3 - Article
C2 - 24879438
SN - 2072-6694
VL - 6
SP - 1195
EP - 1207
JO - Cancers
JF - Cancers
IS - 2
ER -
