ABSTRACT
This chapter describes the methods for detection and enumeration of circulating tumor cells (CTCs). It outlines the clinical implications of CTCs enumeration and molecular profiling and discusses clinical trials that have utilized information from CTCs in the context of personalized medicine. Metastasis is the major cause of death among cancer patients. Despite its vast clinical importance, the molecular and cellular mechanisms involved in the metastatic cascade are poorly understood. Enrichment methods rely on physical characteristics and/or the biological characteristics of tumor cells. CTCs can be detected via Immunocytochemistry (ICC). The Cell Search system is a semi-automated ICC method used for CTCs enumeration. Real-time reverse transcription polymerase chain reaction (RT-PCR) evaluates the presence of CTCs via the detection of CTC-derived mRNA. The process involves RNA extraction from cells in enriched samples, followed by cDNA synthesis by reverse transcription, amplification, and analysis of PCR products. CTCs field focuses on elucidating the clinical relevance of CTCs detected in the blood.
