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The clinical significance of circulating tumor cells

Nature Clinical Practice Oncology volume 4, pages 62–63 (2007)Cite this article

Metastasis is the main cause of cancer-related death, but early spread of tumor cells usually remains undetected even by high-resolution imaging technologies. Sensitive immunocytochemical and molecular assays now enable specific detection of 'occult' disseminated tumor cells (DTCs) at the single-cell stage in cancer patients. The detection of these DTCs years before the onset of overt metastasis could contribute to improved identification of those patients in need of early systemic anticancer therapy.

Recent publications have shown that certain properties of the primary tumor (e.g. expression of the CXC-chemokine receptor CXCR4) enable early hematogenous tumor cell dissemination into the bone marrow.1,2 Interestingly, bone marrow seems to be a common homing organ for DTCs derived from various types of malignant epithelial tumors (e.g. breast, lung, prostate or colorectal cancer).3 Most investigators have used cytokeratins as marker antigens; these cytoskeletal proteins are expressed in all epithelial tumors and are usually absent in hematopoietic cells.3 DTCs are present in bone marrow samples of 20–40% of patients, even in the absence of lymph node metastases (stage N0) or clinical signs of overt distant metastases (stage M0). DTCs are even detected in the bone marrow of patients who have cancers that do not preferably metastasize to the bone (e.g. colon cancer),3 suggesting that bone marrow might be the preferred reservoir for these cells.

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Acknowledgements

The authors would like to acknowledge grant support from the European Commission (DISMALproject, contract No. LSHCCT- 2005-018911), Deutsche Forschungsgemeinschaft (PA341/15-2), and Deutsche Krebshilfe (10-2181-Pa2). Competing interests

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Author notes

  1. C Alix-Panabières is a cellular biologist in the Immuno-Virology Department of the Lapeyronie Hospital at the University Medical Centre of Montpellier, Montpellier, France.

Authors and Affiliations

  1. K Pantel is Professor of Tumour Biology and Chairman of the Institute of Tumour Biology at the University Medical Center Hamburg-Eppendorf, Hamburg, Germany,,

    Klaus Pantel & Catherine Alix-Panabières

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  1. Klaus Pantel
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  2. Catherine Alix-Panabières
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Correspondence to Klaus Pantel.

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Competing interests

K Pantel has received a research grant from Veridex, USA (the distributor of the CellSearch™ system). C Alix-Panabières declared she has no competing interests.

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Pantel, K., Alix-Panabières, C. The clinical significance of circulating tumor cells. Nat Rev Clin Oncol 4, 62–63 (2007). https://doi.org/10.1038/ncponc0737

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