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Circulating tumor cells identified with strong metastatic potential



DOI:10.1038/bonekey.2013.114

A population of circulating tumor cells (CTCs) is theoretically able to initiate distant metastases in bone, lung and liver. Baccelli et al. used a xenograft assay to demonstrate that CTCs in primary human luminal breast cancer contain metastasis-initiating cells (MICs).

The MICs identified within the CTC population expressed several markers—CD44, EPCAM, MET and CD47—that were associated with an increase in metastases and a decrease in overall survival in a mouse model. This finding could suggest new options for therapy to reduce metastasis, or at least to predict in which patients it is most likely to occur.

Editor’s comment: This study provides evidence that patients with metastatic luminal breast cancer have an MIC subpopulation (CD44+CD47+MET+) within EPCAM-positive CTCs that is more predictive of a poor clinical outcome compared with CellSearch-detected bulk CTCs. Yu et al. have shown that epithelial-to-mesenchymal transition occurs in rare cells within primary mammary tumors and more frequently in CTCs from patients with metastatic basal breast cancer. It is not known, however, if a similar MIC subpopulation exists within these mesenchymal (and therefore EPCAM-negative) CTCs. The assessment of CD44+CD47+MET+ as a biomarker of metastasis-initiating CTCs in patients with luminal or basal breast cancer clearly warrants further investigation.


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