Circulating Tumour Cells and Cancer Prognosis
Ujjwala Warawdekar,
Scientific Officer E,
ACTREC
Assessment of Circulating Tumour Cells [CTCs] from the peripheral blood of patients diagnosed with cancer is emerging as a valuable biomarker for prognostication and tailoring therapy. Among all the cancers, breast cancer is the most frequently diagnosed and leading cause of cancer deaths among women, worldwide. The global burden based on estimates by Globocan 2012 shows that breast cancer accounts for 25% of the total new cancer cases and 15% of the total cancer deaths. In India, it has emerged as a leading cause of cancer among women, particularly in the urban and the metropolitan population. It is being viewed as a lifestyle disease and the increased incidence necessitates the need to improve disease prognosis, more so as a large number of the patients at presentation to the clinic are at a greater risk with the spread of the disease to the axillary lymph nodes.
The accuracy of prediction of disease prognosis can be facilitated with robust markers, and numerous clinical studies provide evidence that circulating tumour cells in peripheral blood is an important prognostic marker for cancer Some of these studies have contributed to the demonstration of the presence of CTC in the peripheral blood of patients and their association with tumour progression and metastasis development, as also others have shown that a change in CTC number predicts response to therapy and evaluates residual disease.
There are several technologies which have been developed and are available as cited in literature for CTC-enrichment and detection. The current gold standard that has been widely used in large multi centric clinical trials world-wide and continues to be preferred is the FDA approved quantitative, semi-automated, Cell Search system. Though, this user friendly and clinically accepted system is available, literature shows that almost 60% of studies on detection and enumeration of CTCs have adopted methods using the reverse transcription PCR (RT-PCR), attributed to its sensi
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