Circulating Tumor Cells
Understanding Metastatic Cancer
Understanding Circulating Tumor Cells (CTCs) unlocks a powerhouse of data because CTCs are representative of the underlying tumor profile and CTCs are the primary driver of potentially fatal metastasis. The data that can be derived from CTCs enables the ability to potentially screen and diagnose solid tumors from a simple blood draw, the ability to design and create more efficacious treatments, and the ability to treat the metastatic CTCs themselves to inhibit the progression of metastatic cancer.
There are thousands and thousands of papers demonstrating the value of CTCs. A simple internet search will reveal that CTCs are homologous to the primary tumor, drive metastasis, provide clinically actionable insights for oncologists, and contain powerhouses of diagnostic and therapeutic data.
Understanding CTCs is the key to understanding cancer.
Attacking CTCs - The Drivers of Metastatic Disease
CTCs are highly dangerous cells with the ability to spread cancer to secondary sites, leading to fatality in 90% of solid tumor patients. Current cancer treatments primarily target the primary tumor, overlooking the metastatic spread driven by CTCs, as capturing a representative sample population of CTCs for treatment design has been challenging. Tissue biopsy, the primary method for obtaining genomic data on the primary tumor, is invasive and limited in its ability to capture the evolving mutations of CTCs. Consequently, treatment protocols focus on eradicating the primary tumor, with metastasis addressed as a secondary concern. However, this approach is inherently limited, as CTCs continue to be shed into the bloodstream even after primary tumor treatment, leading to metastases and further tumor heterogeneity. The drugs used to target the primary tumor may not effectively combat the diverse and rapidly mutating CTC population.
With our ability to capture CTCs at scale, genetically analyze them, and identify their tissue of origin, we can offer valuable insights to oncologists on treating CTCs directly to slow metastasis. For instance, if CTCs from a primary breast cancer tumor express a HER2+ mutation, Herceptin could be recommended by the National Comprehensive Cancer Network (NCCN) to address the metastasis. Additionally, CTCs from secondary or tertiary metastatic sites exhibit distinct mutations from the primary tumor, reflecting their adaptation to different microenvironments. Utilizing genomic data from these heterogeneous CTCs alongside NCCN guidelines enables tailored treatment for CTCs themselves. Moreover, this genomic information is invaluable for pharmaceutical companies developing new drugs specifically targeting CTC-driven metastatic disease.
