TEST:

CELLSEARCH®

Simulations predict transitioning high-risk patients (CTC/tdEV score >1.75) to second-line FOLFIRI at week 4 or 10 improves median survival from 15.1 months (12.8-18.4 CI) to 22.7 months (17.1-35.8 CI), and from 13.3 months (10.5-21.7 CI) to 23.3 months (17.8-31.2 CI), respectively...These findings suggest that tdEVs, alone or in combination with CTCs, may help optimize treatment timing and outcomes in mCRC. The integration of CTCs and tdEVs into clinical practice could offer a personalized, cost-effective, and more sustainable alternative to routine imaging in managing advanced colorectal cancer.

Notably, the brightfield imaging strategy eliminates the need for fluorescence microscopy, enabling cost-effective and rapid CTC detection. Together, these results validate the platform's clinical applicability for low-abundance CTC detection and highlight its potential for real-world liquid biopsy-based cancer monitoring.

This consensus offers practical guidance for clinical integration of CTCs and outlines strategic research priorities to unlock their full potential in precision oncology.

Importantly, we also demonstrated the feasibility of processing blood samples of up to 40 mL or 2 × 108 nucleated blood cells in 2.5 min. Overall, our new system provides the advantage of performing ultra-rapid enrichment of CTCs and upscaling the volume of blood that can be analyzed, which opens a new avenue for studies on CTC biology.

Peripheral CTCs isolated from patients with HGSC were predictors of a poor prognosis. The ovarian vein was found to be a rich source of disseminating CTC clusters in HGSC. Further studies are warranted to investigate the utility of CTCs as markers of neoadjuvant chemotherapy response as well as for longitudinal monitoring. Molecular analysis of CTCs in HGSCs reveals a potential role of the immune system in CTC-mediated haematogenous metastasis.

ILC shed more CTCs than NST, likely due to biological differences. While the ≥5 CTC/7.5mL threshold remained a valid prognostic marker for both, it was predictive of chemotherapy benefit in NST, but not ILC. These findings highlight differences in biomarker utility between ILC and NST, affecting both threshold relevance and treatment response.

P=N/A, N=187, Not yet recruiting, Menarini Silicon Biosystems, INC | Initiation date: Jul 2025 --> Oct 2025 | Trial primary completion date: Jul 2027 --> Oct 2027

However, CHC enumeration showed no significant association with clinical outcomes, suggesting sporadic detection rather than consistent prognostic value. These findings underscore the reliability of automated CTC enumeration in mCRC prognosis while highlighting the need for further research into the biological and clinical roles of CHC.

P1/2, N=50, Active, not recruiting, Weill Medical College of Cornell University | Trial completion date: Dec 2025 --> Aug 2026

P1, N=6, Completed, Weill Medical College of Cornell University | Active, not recruiting --> Completed

Baseline CTC enumeration provides significant prognostic information in HR+/HER2- MBC. StageIV aggressive patients derive greater benefit from F+P or F+P+A over F alone, independent of clinical or ctDNA features. This highlights the potential of to guide treatment decision-making.

Postoperative ctDNA and CTC detection both represent strong, independent predictors for a shorter RFS after local treatment, as opposed to preoperative detection. This work was supported by KWF Kankerbestrijding (Dutch Cancer Society, EMCR 2014-6340).