This online seminar will review case studies demonstrating the clinical utility of CTCs and cfDNA to define and characterize a variety of dynamic genomic changes throughout the course of cancer detection and treatment.
As a non-invasive method to improve prognoses, circulating tumor cells (CTCs) provide insights on drug resistance and determine appropriate, targeted cancer treatments. As compared to analyzing a single metastatic biopsy, CTCs provide a more holistic evaluation of metastases; they often demonstrate the same genetic mutations found in metastasized tumors and also reflect intratumoral and intermetastatic heterogeneity. Analysis of CTCs further allows biological characterization of a tumor that is inaccessible or too risky to biopsy. In addition, when collected and evaluated over an extended period of time, the rise and fall of CTC counts can offer clues into the effectiveness of a treatment, indicate the progression of disease, and detect metastatic spread earlier.
The promise of periodic CTC analysis to monitor and treat tumors dynamically can also be extended to cell-free DNA (cfDNA) released from dying tumor cells and CTCs. Like CTCs, tumor-derived cfDNA reflects the genomic alterations of tumors -- but also boasts a short half-life that can indicate tumor changes faster than imaging or conventional biomarkers. Studies have also shown that cfDNA levels can reveal treatment response; amounts increase as a result of disease progression and decline with effective therapies. Also, when coupled with CTC characterization, genomic analysis of cfDNA can provide complementary information to detect mutations, which is especially valuable if CTC counts are lowered from a positive treatment response.
When used together, cfDNA and CTC analyses could lead to more accurate profiling of tumors to detect various mutations, determine markers of resistance, and ultimately design a custom panel for personalized therapies.