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Review
. 2022 Aug 11;14(16):3871.
doi: 10.3390/cancers14163871.

Circulating Cells with Macrophage-like Characteristics in Cancer: The Importance of Circulating Neoplastic-Immune Hybrid Cells in Cancer

Thomas L Sutton  1 , Ranish K Patel  1 , Ashley N Anderson  2 , Stephen G Bowden  3 , Riley Whalen  2 , Nicole R Giske  2 , Melissa H Wong  2   4
Affiliations
Review

Circulating Cells with Macrophage-like Characteristics in Cancer: The Importance of Circulating Neoplastic-Immune Hybrid Cells in Cancer

Thomas L Sutton et al. Cancers (Basel). .

Abstract

Cancer remains a significant cause of mortality in developed countries, due in part to difficulties in early detection, understanding disease biology, and assessing treatment response. If effectively harnessed, circulating biomarkers promise to fulfill these needs through non-invasive "liquid" biopsy. While tumors disseminate genetic material and cellular debris into circulation, identifying clinically relevant information from these analytes has proven difficult. In contrast, cell-based circulating biomarkers have multiple advantages, including a source for tumor DNA and protein, and as a cellular reflection of the evolving tumor. While circulating tumor cells (CTCs) have dominated the circulating cell biomarker field, their clinical utility beyond that of prognostication has remained elusive, due to their rarity. Recently, two novel populations of circulating tumor-immune hybrid cells in cancer have been characterized: cancer-associated macrophage-like cells (CAMLs) and circulating hybrid cells (CHCs). CAMLs are macrophage-like cells containing phagocytosed tumor material, while CHCs can result from cell fusion between cancer and immune cells and play a role in the metastatic cascade. Both are detected in higher numbers than CTCs in peripheral blood and demonstrate utility in prognostication and assessing treatment response. Additionally, both cell populations are heterogeneous in their genetic, transcriptomic, and proteomic signatures, and thus have the potential to inform on heterogeneity within tumors. Herein, we review the advances in this exciting field.

Keywords: CAML; CHC; CTC; fusion; fusion hybrid; liquid biopsy; macrophage-tumor fusion.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Circulating hybrid cells. CAMLs (immune cells), CTCs, and CHCs (neoplastic cells) are disseminated into peripheral blood from the tumor. Monitoring their presence in blood provides different information into the tumor evolution or response to therapy.
See this image and copyright information in PMC

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