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Review
. 2024 Feb 20;165(4):bqae022.
doi: 10.1210/endocr/bqae022.

Dissemination of Circulating Tumor Cells in Breast and Prostate Cancer: Implications for Early Detection

Song Yi Bae  1 , Kaylee Judith Kamalanathan  1 , Catalina Galeano-Garces  1 , Badrinath R Konety  1   2   3 , Emmanuel S Antonarakis  4   5   6 , Jayant Parthasarathy  1 , Jiarong Hong  1   7 , Justin M Drake  1   5   8
Affiliations
Review

Dissemination of Circulating Tumor Cells in Breast and Prostate Cancer: Implications for Early Detection

Song Yi Bae et al. Endocrinology. .

Abstract

Burgeoning evidence suggests that circulating tumor cells (CTCs) may disseminate into blood vessels at an early stage, seeding metastases in various cancers such as breast and prostate cancer. Simultaneously, the early-stage CTCs that settle in metastatic sites [termed disseminated tumor cells (DTCs)] can enter dormancy, marking a potential source of late recurrence and therapy resistance. Thus, the presence of these early CTCs poses risks to patients but also holds potential benefits for early detection and treatment and opportunities for possibly curative interventions. This review delves into the role of early DTCs in driving latent metastasis within breast and prostate cancer, emphasizing the importance of early CTC detection in these diseases. We further explore the correlation between early CTC detection and poor prognoses, which contribute significantly to increased cancer mortality. Consequently, the detection of CTCs at an early stage emerges as a critical imperative for enhancing clinical diagnostics and allowing for early interventions.

Keywords: breast cancer; circulating tumor cells; early detection; prostate cancer; tumor dormancy.

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Figures

Figure 1.
Figure 1.
Two fundamental models of metastasis: linear and parallel progression models. In the linear progression model (right box), cancer cells disseminate into the bloodstream after the development of the primary tumor and then seed into distant site(s) (primary metastasis). This primary metastasis may later disseminate again, resulting in secondary metastasis in other organs. In the parallel progression model (left box), cancer cells disseminate from the early lesion before the malignancy of the primary tumor matures, progressing in multiple sites at different rates.
Figure 2.
Figure 2.
Clinical advantage of early detection of CTCs. The detection of CTCs at an early stage of cancer allows for earlier diagnosis and improved prognosis prediction. Comprehensive analysis of CTCs identifies various subpopulations representing heterogeneous characteristics of primary tumors, potentially leading to metastases at different distant sites. The CTC profile obtained from the analyses enhances patient and disease stage-specific therapy selection and enables the tracking of molecular changes in the tumor over the course of treatment with noninvasive biopsy. Identification and targeting of dormant DTCs may prevent the emergence of late metastasis. Abbreviations: CTC, circulating tumor cells; DTC, disseminated tumor cells.
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