Early Dissemination of Circulating Tumor Cells: Biological and Clinical Insights

Francesca Chemi, Sumitra Mohan, Tatiana Guevara, Alexandra Clipson, Dominic G. Rothwell, Caroline Dive

Research output: Contribution to journalReview articlepeer-review

48 Downloads (Pure)


Circulating tumor cells (CTCs) play a causal role in the development of metastasis, the major cause of cancer-associated mortality worldwide. In the past decade, the development of powerful cellular and molecular technologies has led to a better understanding of the molecular characteristics and timing of dissemination of CTCs during cancer progression. For instance, genotypic and phenotypic characterization of CTCs, at the single cell level, has shown that CTCs are heterogenous, disseminate early and could represent only a minor subpopulation of the primary tumor responsible for disease relapse. While the impact of molecular profiling of CTCs has not yet been translated to the clinic, CTC enumeration has been widely used as a prognostic biomarker to monitor treatment response and to predict disease relapse. However, previous studies have revealed a major challenge: the low abundance of CTCs in the bloodstream of patients with cancer, especially in early stage disease where the identification and characterization of subsequently “lethal” cells has potentially the greatest clinical relevance. The CTC field is rapidly evolving with development of new technologies to improve the sensitivity of CTC detection, enumeration, isolation, and molecular profiling. Here we examine the technical and analytical validity of CTC technologies, we summarize current data on the biology of CTCs that disseminate early and review CTC-based clinical applications.
Original languageEnglish
Article number672195
Pages (from-to)1-11
Number of pages1
JournalFrontiers in Oncology
Publication statusPublished - 7 May 2021


  • CTCs
  • early dissemination
  • liquid biopsy
  • metastasis
  • minimal residual disease

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre


Dive into the research topics of 'Early Dissemination of Circulating Tumor Cells: Biological and Clinical Insights'. Together they form a unique fingerprint.

Cite this