Emerging single-cells technologies open-up the possibility to profile individual circulating cancer cells overcoming the well known cancer heterogeneity. Indeed tumour cells are heterogeneous cells with different phenotypes and genotypes that are responsible for drug resistance and metastasis.

Cancer metastasis of solid tumors happens when the tumor cells enter the blood circulation and disseminate in distant sites. These circulating tumor cells can have a mutational landscape which is different from the primary tumor. Thus therapeutic interventions against the primary tumor could be different from the ones selected to fight metastatic cancer.

Circulating tumor cells (CTCs) represent an effective predictive biomarker and CTC load has been associated with relatively poor prognosis and can be used to monitor therapeutic responses of clinical interventions (The CELLSEARCH® CT Test is the first and only clinically validated, FDA-cleared test, for capturing and enumerating circulating tumor cells -CTCs- to help inform clinical decision making). Tissue biopsies are invasive, costly, and not always feasible. CTCs from peripheral blood can be used as an important source for cell-based liquid biopsies. The assessment of molecular and genomic characteristic of CTCs at single cell resolution contributes to improve the treatment selection and pave the way toward precision diagnosis and personalized medicine for cancer patients.

PDF: Coumans_et al 2018 Cytometry