Cancer and Metastasis Reviews

, Volume 33, Issue 2–3, pp 747–756 | Cite as

Circulating tumour cells—a bona fide cause of metastatic cancer

  • N. J. CaixeiroEmail author
  • N. Kienzle
  • S. H. Lim
  • K. J. Spring
  • A. Tognela
  • K. F. Scott
  • P. de Souza
  • T. M. Becker


Circulating tumour cells (CTCs) are emerging as important prognostic markers and have potential clinical utility as tumour biomarkers for targeted cancer therapy. Although CTCs were proposed more than 100 years ago as potential precursors that may form metastatic lesions, formal evidence that CTCs are indeed capable of initiating metastases is limited. Moreover, the process of CTCs shedding into the circulation, relocating to distant organ sites and initiating metastatic foci is complex and intrinsically inefficient. To partially explain the metastatic process, the concepts of CTCs as metastatic precursors or pre-metastatic conditioners have been proposed; however, it is questionable as to whether these are both variable pathways to metastasis or just markers of metastatic burden. This review explores the evidence for CTCs in the initiation and progression of metastatic cancer and the data supporting these different concepts in an attempt to better understand the role of CTCs in metastasis. A greater understanding of the metastatic potential of CTCs will open new avenues for therapeutic interventions in the future.


Circulating tumour cells Disseminated tumour cells Metastasis Dormancy 



This work was supported by the University of Western Sydney and the University of New South Wales. Funding sources include the Cancer Institute New South Wales for the South West Sydney Translational Cancer Research Unit, University of New South Wales Equipment Grant and Prostate Cancer Foundation of Australia.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • N. J. Caixeiro
    • 1
    • 2
    • 4
    • 7
    Email author
  • N. Kienzle
    • 1
    • 3
  • S. H. Lim
    • 1
    • 3
    • 4
    • 5
  • K. J. Spring
    • 1
    • 2
    • 4
  • A. Tognela
    • 1
    • 2
    • 4
    • 6
  • K. F. Scott
    • 1
    • 2
    • 3
    • 4
  • P. de Souza
    • 1
    • 2
    • 3
    • 4
    • 5
  • T. M. Becker
    • 1
    • 2
    • 3
    • 4
  1. 1.South West Sydney Translational Cancer Research Unit, Ingham Institute for Applied Medical ResearchLiverpool HospitalLiverpoolAustralia
  2. 2.School of MedicineUniversity of Western SydneyLiverpoolAustralia
  3. 3.School of MedicineUniversity of New South WalesKensingtonAustralia
  4. 4.Medical Oncology GroupIngham Institute for Applied Medical ResearchLiverpoolAustralia
  5. 5.Department of Medical OncologyLiverpool HospitalLiverpoolAustralia
  6. 6.Department of Medical OncologyCampbelltown HospitalCampbelltownAustralia
  7. 7.South West Sydney Translational Cancer Research UnitIngham Institute for Applied Medical ResearchLiverpoolAustralia

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