Theranostics 2019; 9(16):4580-4594. doi:10.7150/thno.34337 This issue


Circulating Tumor Cells as a Tool for Assessing Tumor Heterogeneity

Marta Tellez-Gabriel1✉, Marie-Françoise Heymann2,3,4, Dominique Heymann2,3,4✉

1. RNA and molecular pathology (RAMP) research group. Department of Medical Biology. The Artic University of Norway (Tromso), Norway.
2. INSERM, European Associated Laboratory “Sarcoma Research Unit”, Department of Oncology and Metabolism, Medical School, University of Sheffield, United Kingdom.
3. INSERM, Institut de Cancérologie de l'Ouest, LabCT, U1232, CRCINA, Université de Nantes, Université d'Angers, 44805 Saint Herblain cedex, France.
4. Institut de Cancérologie de l'Ouest, “Tumor Heterogeneity and Precision Medicine”, 44805 Saint Herblain cedex, France.

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Tellez-Gabriel M, Heymann MF, Heymann D. Circulating Tumor Cells as a Tool for Assessing Tumor Heterogeneity. Theranostics 2019; 9(16):4580-4594. doi:10.7150/thno.34337. Available from

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Graphic abstract

Tumor heterogeneity is the major cause of failure in cancer prognosis and prediction. Accurately detecting heterogeneity for the development of biomarkers and the detection of the clones resistant to therapy is one of the main goals of contemporary medicine. Metastases belong to the natural history of cancer. The present review gives an overview on the origin of tumor heterogeneity. Recent progress has made it possible to isolate and characterize circulating tumor cells (CTCs), which are the drivers of the disease between the primary sites and metastatic foci. The most recent methods for characterizing CTCs are summarized and we discuss the power of CTC profiling for analyzing tumor heterogeneity in early and advanced diseases.

Keywords: single cell, circulating tumor cell, precision medicine, tumor heterogeneity, omic technologies