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      A revolutionary era in advancing precision immuno-oncology; role of circulating tumor cells

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          Abstract

          Despite a substantial progress in the development of strategies against cancer, cancer still remains a major global health issue due to a high recurrence rate, and severe side effects, leading basic medical scientists and clinical specialists toward more efficient diagnostics, prognostics, and therapeutics. Therefore, there is an imperative need for a comprehensive understanding on the cellular immunopathophysiology involved in the tumor microenvironment. In addition, results from a wide range of studies depicted that an aberration in the cellular mechanisms and immunopathophysiological interactions like Circulating Tumor Cells (CTCs) plays an indispensable role in the metastasis and tumor progression, revolutionizing cancer management by offering non-invasive detection methods and a real-time monitoring of tumor dynamics. Moreover, CTCs can clarify the tumor heterogeneity and the evolution of resistance mechanisms, aiding in the early detection of tumors and informing personalized treatment strategies. An increase in CTCs count can be associated with a worsened cancer prognosis, providing promising biomarkers for tumor phenotyping, tumor spreading or relapse, and monitoring the treatment response in patients with cancer. Hence, this systematic review aims to highlight the diagnostic, prognostic, and therapeutic potentials of CTCs, necessitating further investigations and an interdisciplinary collaboration among basic medical scientists and oncologists to address the current gaps in the strategies of cancer management, precisely improving patient-care and optimized clinical outcomes.

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          Most cited references94

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          Cancer statistics, 2023

          Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence and outcomes using incidence data collected by central cancer registries and mortality data collected by the National Center for Health Statistics. In 2023, 1,958,310 new cancer cases and 609,820 cancer deaths are projected to occur in the United States. Cancer incidence increased for prostate cancer by 3% annually from 2014 through 2019 after two decades of decline, translating to an additional 99,000 new cases; otherwise, however, incidence trends were more favorable in men compared to women. For example, lung cancer in women decreased at one half the pace of men (1.1% vs. 2.6% annually) from 2015 through 2019, and breast and uterine corpus cancers continued to increase, as did liver cancer and melanoma, both of which stabilized in men aged 50 years and older and declined in younger men. However, a 65% drop in cervical cancer incidence during 2012 through 2019 among women in their early 20s, the first cohort to receive the human papillomavirus vaccine, foreshadows steep reductions in the burden of human papillomavirus-associated cancers, the majority of which occur in women. Despite the pandemic, and in contrast with other leading causes of death, the cancer death rate continued to decline from 2019 to 2020 (by 1.5%), contributing to a 33% overall reduction since 1991 and an estimated 3.8 million deaths averted. This progress increasingly reflects advances in treatment, which are particularly evident in the rapid declines in mortality (approximately 2% annually during 2016 through 2020) for leukemia, melanoma, and kidney cancer, despite stable/increasing incidence, and accelerated declines for lung cancer. In summary, although cancer mortality rates continue to decline, future progress may be attenuated by rising incidence for breast, prostate, and uterine corpus cancers, which also happen to have the largest racial disparities in mortality.
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            Molecular principles of metastasis: a hallmark of cancer revisited

            Metastasis is the hallmark of cancer that is responsible for the greatest number of cancer-related deaths. Yet, it remains poorly understood. The continuous evolution of cancer biology research and the emergence of new paradigms in the study of metastasis have revealed some of the molecular underpinnings of this dissemination process. The invading tumor cell, on its way to the target site, interacts with other proteins and cells. Recognition of these interactions improved the understanding of some of the biological principles of the metastatic cell that govern its mobility and plasticity. Communication with the tumor microenvironment allows invading cancer cells to overcome stromal challenges, settle, and colonize. These characteristics of cancer cells are driven by genetic and epigenetic modifications within the tumor cell itself and its microenvironment. Establishing the biological mechanisms of the metastatic process is crucial in finding open therapeutic windows for successful interventions. In this review, the authors explore the recent advancements in the field of metastasis and highlight the latest insights that contribute to shaping this hallmark of cancer.
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              Challenges in liver cancer and possible treatment approaches

              Globally, liver cancer is the most frequent fatal malignancy; in the United States, it ranks fifth. Patients are often diagnosed with liver cancer in advanced stages, contributing to its poor prognosis. Of all liver cancer cases, >90% are hepatocellular carcinomas (HCCs) for which chemotherapy and immunotherapy are the best options for therapy. For liver cancer patients, new treatment options are necessary. Use of natural compounds and/or nanotechnology may provide patients with better outcomes with lower systemic toxicity and fewer side effects. Improved treatments can lead to better prognoses. Finally, in this review, we present some of the problems and current treatment options contributing to the poor outcomes for patients with liver cancer.
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                Author and article information

                Contributors
                Journal
                J Liq Biopsy
                J Liq Biopsy
                The Journal of Liquid Biopsy
                Elsevier
                2950-1954
                11 October 2024
                December 2024
                11 October 2024
                : 6
                : 100169
                Affiliations
                [1]Department of Medical Biology, Faculty of Medicine, Ankara Yildirim Beyazit University (AYBU), Turkey
                Author notes
                [* ]Corresponding author. esimsek@ 123456aybu.edu.tr
                Article
                S2950-1954(24)00034-1 100169
                10.1016/j.jlb.2024.100169
                11863822
                40027303
                902b143f-67a3-488a-99da-0dc3e9c1fd53
                © 2024 Published by Elsevier B.V. on behalf of The International Society of Liquid Biopsy.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 16 September 2024
                : 6 October 2024
                : 7 October 2024
                Categories
                Review

                cancer,circulating tumor cells,cellular immunology,clinical applications,precision medicine,tumor microenvironment

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