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Circulating Tumor Cells: Evolving Evidence and Future Challenges

^aDepartment of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA; ^bDivision of Hematology-Oncology, University Hospitals Case Medical Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA

Key Words. Circulating tumor cells • Breast cancer • Colon cancer • Prostate cancer

Correspondence: Correspondence: Neal J. Meropol, M.D., University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Lakeside 1200, Cleveland, Ohio 44106-5065, USA. Telephone: 216-844-5220; Fax: 216-844-5234; e-mail: neal.meropol{at}case.edu

Received May 15, 2009; accepted for publication October 13, 2009.

Disclosures: Efrat Dotan: None; Steven J. Cohen: Honoraria: Veridex; Katherine R. Alpaugh: None; Neal J. Meropol: None.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the independent peer reviewers.

Circulating tumor cells (CTCs) are rare malignant cells found in the peripheral blood that originate from the primary tumor or metastatic sites. New techniques have been developed to isolate and characterize these cells. CTC enumeration has been incorporated into different fields of oncology as a prognostic marker, a tool to monitor therapy response, and a method to understand basic tumor characteristics. This review covers the different techniques available for isolation of CTCs, the clinical utility of CTCs in breast, prostate, and colon cancer, and future directions in this field.