press release Feb 2012: Scripps invents way to spot spread of cancer | UTSanDiego.com

"The test will require FDA approval before it can move beyond clinical testing.Pathologists and oncologists already have a test, called CellSearch, that’s used to look for CTCs (circulating tumor cells). But Kuhn says physicians need a test that is far more sensitive, and thus more useful for a wide array of cancer patients."

Scientists demonstrate effective new 'biopsy in a blood test' to detect cancer

Blogger's Note: review of 5 studies in various cancers; early and advanced stages

Clinical Oncology News - Circulating Tumor Cells: The Ultimate Assay?

".....But simply being able to predict who will do better and who will do worse is of little value to the patient, other than knowing who needs to get their affairs in order more quickly. Clinical utility depends on actually being able to shape treatment choices based on the information provided in an assay.
Can CTCs do that? Maybe....."

Changes in tumor cells that lead to metastasis CTC's/circulating tumor cells)

ScienceDaily (Jan. 16, 2012) — Researchers at the Centro de Genómica e Investigación Oncológica (GENYO) -of which the University of Granada, Pfizer and the Andalusian Regional Government are members- have identified the genetic and phenotypic changes that cause tumor progression and metastasis. The process of metastasis -- which is the main cause of cancer death -- is caused by tumor cells invading distant organs with no direct anatomical relationship with the organ originally affected. For this to happen, it is necessary that these cells -which researchers call "circulating tumor cells" (CTCs) -, travel to these organs through blood....

"Biodynamics of Circulating Tumor Cell, Tumor Microenvironment and Metastasis," published in the journals Cancer Biology & Therapy, Clinical Translational Oncoly y Annals of Oncology.

abstract : Circulating tumor cells predict progression free survival and overall survival in patients with relapsed/recurrent advanced ovarian cancer - multinational trial

Objective

Serial circulating tumor cell (CTC) counts have demonstrated predictive and prognostic value in patients with metastatic breast, colorectal, and prostate cancer.
In a phase III study of pegylated liposomal doxorubicin (PLD) with trabectedin vs. PLD for relapsed ovarian cancer, we evaluated the correlation, if any, between numbers of CTCs and progression free survival, (PFS) and overall survival (OS).

Conclusions
Results from this study indicate that elevated numbers of CTCs impart an unfavorable prognosis for ovarian cancer patients.

Research highlights

► Circulating tumor cells (CTCs) are prognostic during ovarian cancer therapy.
► Ovarian cancer patients with baseline ≥ 2 CTCs had shorter overall survival time.
► Patients with baseline ≥ 2 CTCs had shorter time to disease progression.

abstract: New technologies for the detection of circulating tumour cells.

"The vast majority of cancer-related death is due to the metastatic spread of the primary tumour. Circulating tumour cells (CTC) are essential for establishing metastasis and their detection has long been considered as a possible tool to assess the aggressiveness of a given tumour and its potential of subsequent growth at distant organs.
Conventional markers are not reliable in detecting occult metastasis and, for example, fail to identify approximately 40% of cancer patients in need of more aggressive or better adjusted therapies. Recent studies in metastatic breast cancer have shown that CTC detection can be used as a marker for overall survival and assessment of the therapeutic response. The benefits of CTC detection in early breast cancer and other solid tumours need further validation.
Moreover, optimal CTC detection techniques are the subject of controversy as several lack reproducibility, sensitivity and/or specificity. Recent technical advances allow CTC detection and characterization at the single-cell level in the blood or in the bone marrow. Their reproducibility propels the use of CTC in cancer staging and real-time monitoring of systemic anticancer therapies in several large clinical trials.
CTC assays are being integrated in large clinical trials to establish their potential in the management of cancer patients and improve our understanding of metastasis biology. This review will focus on the techniques currently used, the technical advancements made, the limitations of CTC detection and future perspectives in this field."