Page 10 - Read Online

Di Raimo et al. J Cancer Metastasis Treat 2018;4:54 Journal of Cancer
DOI: 10.20517/2394-4722.2018.50 Metastasis and Treatment

Review Open Access

Circulating tumor cells and the metastatic process:
the complexity of malignancy

Tania Di Raimo , Elena De Santis , Luigi Coppola , Mario Rosario D’Andrea , Francesco Angelini 1,2
3
1,2
4
1
1 Medical Oncology and Anatomic Pathology Unit, San Filippo Neri Hospital, Rome 00135, Italy.
2 Experimental & Clinical Pharmacology, Centro Di Riferimento Oncologico - National Cancer Center, Aviano (PN) 33081, Italy.
3 Department of Anatomical, Histological, Legal Medical and of the Locomotor Apparatus Sciences, Sapienza University, Rome
00135, Italy.
4 Anatomic Pathology Unit, Sandro Pertini Hospital, Rome 00157, Italy.
Correspondence to: Dr. Francesco Angelini, Medical Oncology and Anatomic Pathology Unit, San Filippo Neri Hospital, Via
Giovanni Martinotti 20, Rome 00135, Italy. E-mail: francescoangelini01@gmail.com

How to cite this article: Di Raimo T, De Santis E, Coppola L, D’Andrea MR, Angelini F. Circulating tumor cells and the metastatic
process: the complexity of malignancy. J Cancer Metastasis Treat 2018;4:54. http://dx.doi.org/10.20517/2394-4722.2018.50

Received: 2 Aug 2018 First Decision: 31 Aug 2018 Revised: 11 Sep 2018 Accepted: 9 Oct 2018 Published: 25 Oct 2018
Science Editor: William Schiemann Copy Editor: Cai-Hong Wang Production Editor: Zhong-Yu Guo

Abstract
Despite improvements achieved in terms of early detection and therapeutic approach, metastatic breast cancer
remains one of the principal worldwide causes of death. In recent years, due to the heterogeneous response of
each patient to chemotherapy, clinical research highlights the need of a personalized approach. Circulating tumor
cells (CTCs) represents a promising tool for this purpose. Unfortunately, even if their correlation with sever-
ity, outcome and metastatic nature of the tumor has been established, several issues, mainly concerning their
characterization and isolation, need to be solved. In this review, latest knowledge on CTCs and metastatic pro-
cess in breast cancer were analyzed, aiming to understand their clinical utility and validity for a prospective ther-
apeutic scenario.

Keywords: Breast cancer, metastasis, circulating tumor cells, personalized therapy

INTRODUCTION
Breast cancer (BC) represents the second leading cause of death among women not only in Western coun-
[1-5]
tries but also, as proved by new evidences, in developing countries . BC has been defined as a heteroge-
neous disease with multiple intrinsic tumor subtypes and the possibility to develop one of them is directly
related to many factors, such as aging, genetics and lifestyle (obesity, lack of physical activity, sedentary
[6-8]
behavior and frequent alcohol consumption) . Furthermore, each BC subtype, with distinctive histopath-

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.jcmtjournal.com