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Circulating tumour cells and the epithelial mesenchymal transition in colorectal cancer
  1. S H-S Lim1,2,3,4,
  2. T M Becker1,3,4,5,
  3. W Chua2,4,
  4. W L Ng2,4,
  5. P de Souza1,2,3,4,5,
  6. K J Spring1,3,4,5
  1. 1Medical Oncology, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
  2. 2Department of Medical Oncology, Liverpool Hospital, Liverpool, New South Wales, Australia
  3. 3School of Medicine, University of New South Wales, Kensington, New South Wales, Australia
  4. 4CONCERT-Translational Cancer Research Centre, Liverpool, New South Wales, Australia
  5. 5Liverpool Clinical School, University of Western Sydney, Liverpool, New South Wales, Australia
  1. Correspondence to Dr Stephanie Hui-Su Lim, Medical Oncology, Ingham Institute for Applied Medical Research, 1 Campbell St, Liverpool, NSW 2170, Australia; stephanie.lim{at}


Circulating tumour cells (CTCs) hold great potential as liquid biopsies to prognosticate disease and guide treatment in colorectal cancer. However, their emerging role in determining the molecular phenotype of tumour metastasis carries even more promising clinical use in the provision of comprehensive biomarker detection for targeted therapies and determination of drug resistance. The isolation of CTCs is technology dependent, and in the case of epithelial cell adhesion molecule-based platforms, the ability to detect cells that have undergone the epithelial to mesenchymal transition (EMT) is ineffective. CTCs displaying a mesenchymal phenotype are believed to have an increased metastatic potential. The rarity of CTCs provides another challenge in the enumeration of these cells. The future will likely involve the analysis of individual CTCs at any stage of the EMT in order to provide real-time phenotypic and molecular snapshots capable of tracking the dynamic evolution of tumour progression over time.


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