Circulating Tumor Cells – Isolation, Characterization and Applications for Diagnosis & Therapies for Breast Cancer
Pravin Potdar, Head, Jaslok Hospital & Research Centre
Circulating Tumor Cells (CTCs) in the blood stream play a
critical role in establishing metastases in breast, lung, colon, prostate &
pancreatic cancers. Last few years detection of CTC from circulating blood
cells of cancer patients holds great promise in the field of Medicine. These
circulating tumor cells (CTCs) can be enriched and detected via different
technologies and thus the clinical value
of CTCs have been widely explored as a biomarker for early detection & therapeutic management of metastatic
cancers. This liquid biopsy allows the characterization of specific
sub-populations of CTCs and may revolutionize cancer detection and management. Even
though CTC detection holds great promise in Medical Sciences, it remains
technically very challenging because of very low concentration CTC in blood
stream of these patients. A large panel of technologies is based on
identification of different properties of CTCs including physical and
biological properties
that distinguish them from the surrounding normal blood cells. Presently, CTCs
are identified as CK+ /CD45- /DAPI+ cells. In breast cancer, the
CK19 mRNA has been most frequently used in clinical studies. However, many times
CK18, CK19, CK20, MUC1, PSA, and CEA are also
expressed at low levels in normal blood and BM cells. Therefore quantitative
RT-PCR assays with validated cut-off values are required to overcome this
problem. The detection and molecular characterization of CTCs is one of the
most active areas of translational cancer research to include CTCs as a
potential biomarker for cancer diagnosis and therapies. In near future, CTC
characterization will contribute to have specific targeted therapies for cancer
patients at a certain therapeutic level and become the hallmark of personalized
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