Evaluation and consequences of heterogeneity in the circulating tumor cell compartment

Anja Brouwer _, Bram De Laere, Dieter Peeters, Marc Peeters, Roberto Salgado, Luc Dirix and Steven Van Laere

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Oncotarget. 2016; 7:48625-48643. https://doi.org/10.18632/oncotarget.8015

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Anja Brouwer1,2, Bram De Laere1, Dieter Peeters1,3, Marc Peeters1,2, Roberto Salgado1,3,5, Luc Dirix1,4, Steven Van Laere1

1Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium

2Department of Oncology, Antwerp University Hospital, Antwerp, Belgium

3Department of Pathology, GZA Hospitals Sint-Augustinus, Antwerp, Belgium

4Department of Oncology, GZA Hospitals Sint-Augustinus, Antwerp, Belgium

5Breast Cancer Translational Research Laboratory, Jules Bordet Institute, Brussels, Belgium

Correspondence to:

Anja Brouwer, email: [email protected]

Keywords: circulating tumor cells, heterogeneity, liquid biopsy

Received: November 06, 2015     Accepted: February 18, 2016     Published: March 09, 2016


A growing understanding of the molecular biology of cancer and the identification of specific aberrations driving cancer evolution have led to the development of various targeted agents. Therapeutic decisions concerning these drugs are often guided by single biopsies of the primary tumor. Yet, it is well known that tumors can exhibit significant heterogeneity and change over time as a result of selective pressure. Circulating tumor cells (CTCs) are shed from various tumor sites and are thought to represent the molecular landscape of a patient’s overall tumor burden. Moreover, a minimal-invasive liquid biopsy facilitates monitoring of clonal evolution during therapy pressure and disease progression in real-time. While more information becomes available regarding heterogeneity among CTCs, comparison between these studies is needed. In this review, we focus on the genomic and transcriptional heterogeneity found in the CTC compartment, and its significance for clinical decision making.

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