Bonekey Rep. 2014 Nov 19;3:584. eCollection 2014.

Bone marrow as a reservoir for disseminated tumor cells: a special source for liquid biopsy in cancer patients.

Pantel K1, Alix-Panabières C2.

Author information

• 1Department of Tumor Biology, University Medical Center , Hamburg, Germany.
• 2Laboratory of Rare Human Circulating Cells, Department of Cellular and Tissular Biopathology, Cell and Tissue Biopathology of Tumors Department, Institute of Research in Biotherapy, University Medical Centre, Saint-Eloi Hospital , Montpellier, France ; University Institute of Clinical Research, University Montpellier 1-Epidemiology, Biostatistics and Public Health , Montpellier, France.

Abstract

Besides circulating tumor cells, disseminated tumor cells (DTCs) in bone marrow (BM) might be used as a 'liquid biopsy' to obtain information helpful to steer therapies in individual patients. Moreover, the molecular characterization of DTCs may provide important insight into the biology of cancermetastasis. BM is a frequent site of metastasis in breast, prostate and lung cancer, and it might represent a sanctuary site for DTCs derived from various additional types of epithelial tumors. Highly sensitive and specific immunocytological and molecular methods enable the detection of DTCs in BM of cancer patients at the single-cell level years before the occurrence of metastases. This information might be useful to assess individual prognosis and stratify patients at risk to systemic adjuvant anti-cancer therapies. Although most data on the prognostic value of DTCs are available for breast cancer, several single institution studies including patients with colon, lung, prostate, esophageal, gastric, pancreatic, ovarian and head and neck carcinomas have also documented an association between the presence of DTCs at primary surgery and subsequent metastatic relapse. Most DTCs are in a dormant (that is, non-proliferative) stage, frequently express HER2 and display a cancer stem cell and immune escape phenotype. Here, we summarize the current knowledge about specific biological properties of DTCs in BM, and discuss the clinical relevance of DTC detection in cancer patients with regard to an improved individualized therapeutic management. This will stimulate further technical developments that may make BM sampling more acceptable for the clinical management of patients with solid tumors.