Circulating Tumor Cell Kinetics and Morphology from the Liquid Biopsy Predict Disease Progression in Patients with Metastatic Colorectal Cancer Following Resection
Abstract
As a minimally invasive procedure, the liquid biopsy enables the longitudinal evaluation of a patient's disease and response to treatment. Current clinical practice stratifies patient status based on a uniform threshold for circulating tumor cell (CTC) positivity, overlooking various cell subtypes and timepoints of sample collection.
In a disease known for its tumor heterogeneity, we investigated colorectal cancer patients' peripheral blood samples to determine whether the prevalence of morphologically distinct CTC subtypes and time-points of sample collection correlate with clinical disease hallmarks and survival data. Our results highlight nuances between the CTC subtypes' clinical and survival significance.
Furthermore, we found that time-point-conscious cell enumeration is critical, both for determining CTC positivity and the change in cell populations over time. To improve its clinical utility moving forward, we suggest that liquid biopsy analysis integrates morphology and time-based analysis alongside standard CTC enumeration at various stages of a patient's treatment.