Isolation of circulating tumor cells

Circulating tumor cells (CTCs) enter the vasculature from solid tumors and disseminate widely to initiate metastases. Mining the metastatic-enriched molecular signatures of CTCs before, during, and after treatment holds unique potential in personalized oncology. Their extreme rarity, however, requires isolation from large blood volumes at high yield and purity, yet they overlap leukocytes in size and other biophysical properties. Additionally, many CTCs lack EpCAM that underlies much of affinity-based capture, complicating their separation from blood. Here, we provide a comprehensive introduction of CTC isolation technology, by analyzing key separation modes and integrated isolation strategies. Attention is focused on recent progress in microfluidics, where an accelerating evolution is occurring in high-throughput sorting of cells along multiple dimensions.

Automated summary

Circulating tumor cells (CTCs), which enter the bloodstream from solid tumors, have the potential to initiate metastases. However, due to their extreme rarity and similarities to leukocytes, isolating CTCs from large blood volumes at high yield and purity remains a challenge. Recent advancements in microfluidics have allowed for high-throughput sorting of cells along multiple dimensions.