domingo, 18 de marzo de 2018

Circulating tumor cells in bladder cancer: Emerging technologies and clinical implications foreseeing precision oncology. - PubMed - NCBI

2018 Mar 9. pii: S1078-1439(18)30044-9. doi: 10.1016/j.urolonc.2018.02.004. [Epub ahead of print]

Circulating tumor cells in bladder cancer: Emerging technologies and clinical implications foreseeing precision oncology.

Azevedo R1, Soares J2, Peixoto A3, Cotton S2, Lima L4, Santos LL5, Ferreira JA6.

Author information

Abstract

CONTEXT:

Circulating tumor cells (CTC) in peripheral blood of cancer patients provide an opportunity for real-time liquid biopsies capable of aiding early intervention, therapeutic decision, response to therapy, and prognostication. Nevertheless, the rare and potentially heterogeneous molecular nature of CTC has delayed the standardization of robust high-throughput capture/enrichment and characterization technologies.

OBJECTIVE:

This review aims to systematize emerging solutions for CTC analysis in bladder cancer (BC), their opportunities and limitations, while providing key insights on specific technologic aspects that may ultimately guide molecular studies and clinical implementation.

EVIDENCE ACQUISITION:

State-of-the-art screening for CTC technologies and clinical applications in BC was conducted in MEDLINE through PubMed.

EVIDENCE SYNTHESIS:

From 200 records identified by the search query, 25 original studies and 1 meta-analysis met the full criteria for selection. A significant myriad of CTC technological platforms, including immunoaffinity, biophysical, and direct CTC detection by molecular methods have been presented. Despite their preliminary nature and irrespective of the applied technology, most studies concluded that CTC counts in peripheral blood correlated with metastasis. Associations with advanced tumor stage and grade and worst prognosis have been suggested. However, the unspecific nature, low sensitivity, and the lack of standardization of current methods still constitutes a major drawback. Moreover, few comprehensive molecular studies have been conducted on these poorly known class of malignant cells.

CONCLUSION:

The current rationale supports the importance of moving the CTC field beyond proof of concept studies toward molecular-based solutions capable of improving disease management. The road has been paved for identification of highly specific CTC biomarkers and novel targeted approaches, foreseeing successful clinical applications.