Journal of Molecular Medicine

, Volume 95, Issue 2, pp 133–142 | Cite as

Epithelial-mesenchymal plasticity in circulating tumor cells

  • Catherine Alix-PanabièresEmail author
  • Sonja Mader
  • Klaus PantelEmail author


Epithelial-to-Mesenchymal Transition (EMT) is a complex process that supports the migratory capacity of epithelial tumor cells and is thought to play a crucial role in promoting cancer metastasis. Despite the wealth of experimental data, the exact role of EMT in cancer patients remains more controversial. Over the past 10 years, sensitive technologies that allow the detection and molecular characterization of circulating tumor cells (CTCs) in the peripheral blood of tumor patients have been developed. These analyses help to shed new light into the importance of EMT for human tumor cell dissemination. CTCs with mesenchymal features can be attributed in some clinical studies (in particularly on breast cancer) to higher disease stages, presence of metastases, and even to therapy response and worse outcome. However, the published studies addressing the impact of mesenchymal-like CTCs show heterogeneity with regard to assay specificity, size of cancer and control groups, and endpoint parameters. In the present review, we present the key features of the biology of CTCs in relation to epithelial-to-mesenchy-mal plasticity, describe the current technologies for enrichment and detection of CTCs with high epithelial-mesenchymal plasticity, and discuss the clinical studies that have assessed the relevance of mesenchymal CTCs in carcinoma patients.


Circulating tumor cells Epithelial-to-mesenchymal transition Tumor cell plasticity Cancer progression Tumor dissemination 



Epithelial cell adhesion molecule


Epithelial-to-mesenchymal transition









The authors receive support from CANCER-ID, an Innovative Medicines Initiative Joint Undertaking under grant agreement no. 115749, resources of which are composed of financial contribution from the European Union’s Seventh Framework Program (FP7/2007–2013) and EFPIA companies’ in-kind contribution. This work was further supported by the FEDER plus the Region Languedoc-Roussillon (GEPETOS project) and the National Institute of Cancer (INCA; to C. Alix-Panabières), and the European Research Council Advanced Investigator grant no. 269081 DISSECT (to K. Pantel).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Laboratory of Rare Human Circulating Cells (LCCRH), Department of Cellular and Tissular Biopathology of TumorsUniversity Medical CentreMontpellier Cedex 5France
  2. 2.EA2415 – Help for Personalized Decision: Methodological AspectsUniversity Institute of Clinical Research (IURC)MontpellierFrance
  3. 3.Department of Tumor Biology, Center of Experimental MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany

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