Circulating tumors cells as biomarkers: Progress toward biomarker qualification Journal Article


Authors: Danila, D. C.; Pantel, K.; Fleisher, M.; Scher, H. I.
Article Title: Circulating tumors cells as biomarkers: Progress toward biomarker qualification
Abstract: Personalized cancer medicine requires the development of tumor-specific biomarkers to optimize selection of targeted therapies and to better assess response to therapy. Current efforts in several tumor types have shown that patients in whom circulating tumor cells (CTCs) are detected have an inferior prognosis relative to those in whom CTCs are not detected and that the elimination or decrease of CTCs following treatment is associated with improved clinical outcomes. Technological advances in the detection, isolation, capture, and characterization of CTCs from phlebotomy samples obtained in a routine clinical practice setting have enabled the evaluation of different CTC biomarkers. Unmet needs in cancer diagnosis and treatment where CTC biomarkers have been studied include determining prognosis, assessing the effects of treatment, and as a source of tumor for the biologic identification and characterization of determinants to predict sensitivity to one form of treatment versus another and to understand mechanisms of treatment resistance. At present, there is no single definition of a CTC and no single CTC "biomarker." Rather, multiple assays (tests) are in development for CTC biomarkers. However, before the role of any biomarker in medical decision making can be determined, it is essential that the assays used to measure the biomarker are analytically validated in a sequence of trials to generate the evidence to support the biomarker's use in the given context of use. It is against this background that this review focuses on the process of developing CTC biomarker assays, with the objective of outlining the necessary steps to qualify specific CTC tests for medical decision making in clinical practice or drug development. The potential for point-of-care tests is clear. Copyright © 2011 by Lippincott Williams & Wilkins.
Keywords: treatment outcome; review; cancer patient; flow cytometry; clinical practice; neoplasms; colorectal cancer; biological marker; reverse transcription polymerase chain reaction; breast cancer; tumor markers, biological; cancer resistance; prostate cancer; neoplastic cells, circulating; biomarker; immunomagnetic separation; cell isolation; circulating tumor cells; electrophoresis; personalized medicine; circulating tumor cell; clinical trial (topic); phlebotomy; regulatory qualification; microfiltration
Journal Title: The Cancer Journal
Volume: 17
Issue: 6
ISSN: 1528-9117
Publisher: Lippincott Williams & Wilkins  
Date Published: 2011-11-01
Start Page: 438
End Page: 450
Language: English
DOI: 10.1097/PPO.0b013e31823e69ac
PROVIDER: scopus
PUBMED: 22157288
PMCID: PMC3985131
DOI/URL:
Notes: --- - "Export Date: 1 February 2012" - "CODEN: CAJOC" - "Source: Scopus"
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  1. Martin Fleisher
    312 Fleisher
  2. Howard Scher
    1130 Scher
  3. Daniel C Danila
    154 Danila