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Review
. 2020 Nov 30;12(12):3588.
doi: 10.3390/cancers12123588.

Mesenchymal Characteristics and Predictive Biomarkers on Circulating Tumor Cells for Therapeutic Strategy

Takahiro Okabe  1 , Shinsaku Togo  2   3 , Yuichi Fujimoto  2   3 , Junko Watanabe  2   3 , Issei Sumiyoshi  2   3 , Akira Orimo  4 , Kazuhisa Takahashi  2   3
Affiliations
Review

Mesenchymal Characteristics and Predictive Biomarkers on Circulating Tumor Cells for Therapeutic Strategy

Takahiro Okabe et al. Cancers (Basel). .

Abstract

Metastasis-related events are the primary cause of cancer-related deaths, and circulating tumor cells (CTCs) have a pivotal role in metastatic relapse. CTCs include a variety of subtypes with different functional characteristics. Interestingly, the epithelial-mesenchymal transition (EMT) markers expressed in CTCs are strongly associated with poor clinical outcome and related to the acquisition of circulating tumor stem cell (CTSC) features. Recent studies have revealed the existence of CTC clusters, also called circulating tumor microemboli (CTM), which have a high metastatic potential. In this review, we present current opinions regarding the clinical significance of CTCs and CTM with a mesenchymal phenotype as clinical surrogate markers, and we summarize the therapeutic strategy according to phenotype characterization of CTCs in various types of cancers for future precision medicine.

Keywords: circulating tumor cells; circulating tumor microemboli; epithelial–mesenchymal transition.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic representation of circulating tumor cells (CTCs) during the metastatic process and characterization as a clinical biomarker after isolation. During the metastatic process, CTCs undergo gradual or full epithelial-to-mesenchymal transition (EMT) by which the primary epithelial tumor cells acquire mesenchymal characteristics and enhance metastatic and invasive abilities. Circulating tumor stem cells (CTSCs) exhibit the stem cell properties and the mesenchymal phenotype. Circulating tumor microemboli (CTM) are the CTC clusters, which often appear to be a heterogeneous cell population. The presence of CTCs and CTM with mesenchymal markers associate with chemoresistance and poor clinical outcomes, and the detection of these cells has significance as surrogate biomarkers for decision-making in therapeutic strategy.
See this image and copyright information in PMC

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