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Review

A Review of Circulating Tumour Cell Enrichment Technologies

1
Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
2
Leicester Cancer Research Centre, University of Leicester, Leicester LE2 7LX, UK
*
Author to whom correspondence should be addressed.
Academic Editor: Elin S. Gray
Cancers 2021, 13(5), 970; https://doi.org/10.3390/cancers13050970
Received: 21 January 2021 / Revised: 22 February 2021 / Accepted: 23 February 2021 / Published: 26 February 2021
Circulating tumour cells (CTCs) are cancer cells shed into the bloodstream from tumours and their analysis can provide important insights into cancer detection and monitoring, with the potential to direct personalised therapies for the patient. These CTCs are rare in the blood, which makes their detection and enrichment challenging and to date, only one technology (the CellSearch) has gained FDA approval for determining the prognosis of patients with advanced breast, prostate and colorectal cancers. Here, we review the wide range of enrichment technologies available to isolate CTCs from other blood components and highlight the important characteristics that new technologies should possess for routine clinical use.
Circulating tumour cells (CTCs) are the precursor cells for the formation of metastatic disease. With a simple blood draw, liquid biopsies enable the non-invasive sampling of CTCs from the blood, which have the potential to provide important insights into cancer detection and monitoring. Since gaining FDA approval in 2004, the CellSearch system has been used to determine the prognosis of patients with metastatic breast, prostate and colorectal cancers. This utilises the cell surface marker Epithelial Cell Adhesion Molecule (EpCAM), to enrich CTCs, and many other technologies have adopted this approach. More recently, the role of mesenchymal-like CTCs in metastasis formation has come to light. It has been suggested that these cells are more aggressive metastatic precursors than their epithelial counterparts; however, mesenchymal CTCs remain undetected by EpCAM-based enrichment methods. This has prompted the development of a variety of ‘label free’ enrichment technologies, which exploit the unique physical properties of CTCs (such as size and deformability) compared to other blood components. Here, we review a wide range of both immunocapture and label free CTC enrichment technologies, summarising the most significant advantages and disadvantages of each. We also highlight the important characteristics that technologies should possess for routine clinical use, since future developments could have important clinical implications, with the potential to direct personalised therapies for patients with cancer. View Full-Text
Keywords: circulating tumour cell (CTC); cancer; metastasis; liquid biopsy circulating tumour cell (CTC); cancer; metastasis; liquid biopsy
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MDPI and ACS Style

Rushton, A.J.; Nteliopoulos, G.; Shaw, J.A.; Coombes, R.C. A Review of Circulating Tumour Cell Enrichment Technologies. Cancers 2021, 13, 970. https://doi.org/10.3390/cancers13050970

AMA Style

Rushton AJ, Nteliopoulos G, Shaw JA, Coombes RC. A Review of Circulating Tumour Cell Enrichment Technologies. Cancers. 2021; 13(5):970. https://doi.org/10.3390/cancers13050970

Chicago/Turabian Style

Rushton, Amelia J.; Nteliopoulos, Georgios; Shaw, Jacqueline A.; Coombes, R. C. 2021. "A Review of Circulating Tumour Cell Enrichment Technologies" Cancers 13, no. 5: 970. https://doi.org/10.3390/cancers13050970

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