The Circulating Tumor Microenvironment (cTME): Emerging Taxonomies and Multimodal Landscapes

A special issue of Cells (ISSN 2073-4409). This special issue belongs to the section "Cell Microenvironment".

Deadline for manuscript submissions: 20 August 2026 | Viewed by 616

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Guest Editor
1. Department of General Thoracic Surgery, Kawanishi City Medical Center, 1-4-1 HiuchiKawanishi, Hyogo 666-0017, Japan
2. Department of Diagnostic Pathology, Nara Medical University Hospital, 840 Shijo-Cho, Kashihara 634-8522, Nara, Japan
Interests: thoracic surgery; oncology; liquid biopsy; circulating tumor cells (CTCs); the circulating tumor microenvironment (cTME)
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Special Issue Information

Dear Colleagues,

The traditional paradigm of cancer metastasis has long focused on solitary circulating tumor cells (CTCs) as the primary “seeds” of disease progression. However, emerging research indicates that metastasis is a coordinated, collective process governed by a complex systemic ecosystem known as the Circulating Tumor Microenvironment (cTME). This ecosystem encompasses not only malignant cells but also a diverse array of non-malignant functional partners—including tumor-associated macrophages (TAMs), fibroblasts (CAFs), and aneuploid circulating tumor endothelial cells (CTECs). These components, along with non-cellular factors such as ctDNA and extracellular vesicles (EVs), dictate the survival, immune evasion, and seeding efficiency of the metastatic unit.

Despite rapid discovery, the field faces a significant nomenclature inconsistency regarding the term “TME,” which historically denoted physical cell clusters (Tumor Microemboli) but now universally refers to the broader biological landscape. Establishing a rigorous taxonomy to decouple the “environment” (cTME) from the “physical emboli” (CTE) is essential to advance experimental cytology and bridge the gap between molecular profiling and functional assays.

This Special Issue aims to present and disseminate the most recent advances related to the biological and cellular dynamics of the circulating tumor ecosystem. We encourage submissions addressing a broad spectrum of solid tumors, including but not limited to lung cancer and breast cancer, to provide a comprehensive overview of the cTME landscape. We specifically invite contributions that delve into the cellular mechanisms and functional assays of the cTME.

Topics of interest for publication include, but are not limited to, the following:

  • Cellular heterogeneity and phenotypic plasticity of CTCs and C-TACs;
  • Mechanisms of heterotypic cluster (CTE) formation and the “mobile niche” in immune evasion;
  • Molecular characterization of cTME-derived extracellular vesicles (EVs) and pre-metastatic niche preparation;
  • Biophysical regulation of tumor cell transit, including fluid shear stress and extravasation;
  • Novel technologies for the selective enrichment and functional profiling (e.g., Chemo-Response Profiling) of cTME components.

Prof. Dr. Noriyoshi Sawabata
Guest Editor

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Keywords

  • circulating tumor microenvironment (cTME)
  • circulating tumor-associated cells (C-TACs)
  • circulating tumor emboli (CTE)
  • extracellular vesicles
  • metastatic cascade
  • experimental cytology
  • functional assays
  • precision oncology
  • liquid biopsy
  • next-generation sequencing (NGS)

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Published Papers (1 paper)

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Review

22 pages, 2500 KB  
Review
A Unified Taxonomy for the Circulating Tumor Microenvironment (cTME) and Circulating Tumor-Associated Cells (C-TACs): A Conceptual Framework for Precision Oncology
by Noriyoshi Sawabata
Cells 2026, 15(12), 1108; https://doi.org/10.3390/cells15121108 - 18 Jun 2026
Viewed by 325
Abstract
Background: The growing complexity of liquid biopsy in precision oncology demands a structured classification framework that can accommodate its expanding multi-omic scope. As the field has matured from early Tumor Microemboli research—focused on multicellular clusters of circulating tumor cells (CTCs) that drive high-efficiency [...] Read more.
Background: The growing complexity of liquid biopsy in precision oncology demands a structured classification framework that can accommodate its expanding multi-omic scope. As the field has matured from early Tumor Microemboli research—focused on multicellular clusters of circulating tumor cells (CTCs) that drive high-efficiency metastasis—to the broader systemic analysis of the “Tumor Microenvironment” (TME) encompassing malignant and non-malignant components, the need for a hierarchical taxonomy has become evident. Objective: To integrate these diverse data streams into a coherent clinical framework, a multi-tiered classification system is needed. This review proposes a foundational roadmap that formally distinguishes the systemic ecosystem from its physical and functional subsets and highlights their clinical utility in therapeutic decision-making. Proposed Taxonomy: We advocate for the adoption of Circulating Tumor Microenvironment (cTME) as the inclusive term for the systemic environment, encompassing non-cellular factors such as ctDNA, extracellular vesicles, and biophysical attributes. Conversely, physical cellular clusters should be strictly classified as Circulating Tumor Emboli (CTE). Crucially, we define Circulating Tumor-Associated Cells (C-TACs) as the functional cellular subset within the cTME, encompassing single CTCs, CTE, and supporting non-malignant cells like CTECs and CAFs. Clinical Applications: Establishing this distinction allows for the seamless integration of molecular profiling (NGS) and functional assays. We highlight emerging evidence that C-TACs may serve as the primary substrate for Chemo-Response Profiling (CRP), with early proof-of-concept studies reporting high concordance with clinical outcomes that still await independent prospective confirmation. Furthermore, preliminary evidence suggests that identifying these functional units, particularly perioperative CTE, may help predict the efficacy of adjuvant chemotherapy in early-stage malignancies, although this remains to be confirmed in prospective studies. Conclusions: Adopting this unified taxonomy may help advance precision oncology. By recognizing the cTME as the superordinate ecosystem and C-TACs as its functional executors, clinicians may be better positioned to interpret multi-modal liquid biopsy data, providing a conceptual roadmap for integrating these technologies into platforms for personalized cancer management. We emphasize that this framework is intended to be hypothesis-generating and that its clinical applications require prospective validation before routine adoption. Full article
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