author_facet Hayes, D. F.
Paoletti, C.
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Paoletti, C.
author Hayes, D. F.
Paoletti, C.
spellingShingle Hayes, D. F.
Paoletti, C.
Journal of Internal Medicine
Circulating tumour cells: insights into tumour heterogeneity
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spelling Hayes, D. F. Paoletti, C. 0954-6820 1365-2796 Wiley Internal Medicine http://dx.doi.org/10.1111/joim.12047 <jats:title>Abstract</jats:title><jats:p>Tumour heterogeneity is a major barrier to cure breast cancer. It can exist between patients with different intrinsic subtypes of breast cancer or within an individual patient with breast cancer. In the latter case, heterogeneity has been observed between different metastatic sites, between metastatic sites and the original primary tumour, and even within a single tumour at either a metastatic or a primary site. Tumour heterogeneity is a function of two separate, although linked, processes. First, genetic instability is a hallmark of malignancy, and results in ‘fixed’ genetic changes that are almost certainly carried forward through progression of the cancer over time, with increasingly complex additional genetic changes in new metastases as they arise. The second type of heterogeneity is due to differential but ‘plastic’ expression of various genes important in the biology and response to various therapies. Together, these processes result in highly variable cancers with differential response, and resistance, to both targeted (e.g. endocrine or anti‐human epithelial growth receptor type 2 (<jats:styled-content style="fixed-case">HER</jats:styled-content>2) agents) and nontargeted therapies (e.g. chemotherapy). Ideally, tumour heterogeneity would be monitored over time, especially in relation to therapeutic strategies. However, biopsies of metastases require invasive and costly procedures, and biopsies of multiple metastases, or serially over time, are impractical. Circulating tumour cells (<jats:styled-content style="fixed-case">CTC</jats:styled-content>s) represent a potential surrogate for tissue‐based cancer and therefore might provide the opportunity to monitor serial changes in tumour biology. Recent advances have enabled accurate and reliable quantification and molecular characterization of <jats:styled-content style="fixed-case">CTC</jats:styled-content>s with regard to a number of important biomarkers including oestrogen receptor alpha and <jats:styled-content style="fixed-case">HER</jats:styled-content>2. Preliminary data have demonstrated that expression of these markers between <jats:styled-content style="fixed-case">CTC</jats:styled-content>s in individual patients with metastatic breast cancer reflects the heterogeneity of the underlying tumours. Future studies are designed to determine the clinical utility of these novel technologies in either research or routine clinical settings.</jats:p> Circulating tumour cells: insights into tumour heterogeneity Journal of Internal Medicine
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title Circulating tumour cells: insights into tumour heterogeneity
title_unstemmed Circulating tumour cells: insights into tumour heterogeneity
title_full Circulating tumour cells: insights into tumour heterogeneity
title_fullStr Circulating tumour cells: insights into tumour heterogeneity
title_full_unstemmed Circulating tumour cells: insights into tumour heterogeneity
title_short Circulating tumour cells: insights into tumour heterogeneity
title_sort circulating tumour cells: insights into tumour heterogeneity
topic Internal Medicine
url http://dx.doi.org/10.1111/joim.12047
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description <jats:title>Abstract</jats:title><jats:p>Tumour heterogeneity is a major barrier to cure breast cancer. It can exist between patients with different intrinsic subtypes of breast cancer or within an individual patient with breast cancer. In the latter case, heterogeneity has been observed between different metastatic sites, between metastatic sites and the original primary tumour, and even within a single tumour at either a metastatic or a primary site. Tumour heterogeneity is a function of two separate, although linked, processes. First, genetic instability is a hallmark of malignancy, and results in ‘fixed’ genetic changes that are almost certainly carried forward through progression of the cancer over time, with increasingly complex additional genetic changes in new metastases as they arise. The second type of heterogeneity is due to differential but ‘plastic’ expression of various genes important in the biology and response to various therapies. Together, these processes result in highly variable cancers with differential response, and resistance, to both targeted (e.g. endocrine or anti‐human epithelial growth receptor type 2 (<jats:styled-content style="fixed-case">HER</jats:styled-content>2) agents) and nontargeted therapies (e.g. chemotherapy). Ideally, tumour heterogeneity would be monitored over time, especially in relation to therapeutic strategies. However, biopsies of metastases require invasive and costly procedures, and biopsies of multiple metastases, or serially over time, are impractical. Circulating tumour cells (<jats:styled-content style="fixed-case">CTC</jats:styled-content>s) represent a potential surrogate for tissue‐based cancer and therefore might provide the opportunity to monitor serial changes in tumour biology. Recent advances have enabled accurate and reliable quantification and molecular characterization of <jats:styled-content style="fixed-case">CTC</jats:styled-content>s with regard to a number of important biomarkers including oestrogen receptor alpha and <jats:styled-content style="fixed-case">HER</jats:styled-content>2. Preliminary data have demonstrated that expression of these markers between <jats:styled-content style="fixed-case">CTC</jats:styled-content>s in individual patients with metastatic breast cancer reflects the heterogeneity of the underlying tumours. Future studies are designed to determine the clinical utility of these novel technologies in either research or routine clinical settings.</jats:p>
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description <jats:title>Abstract</jats:title><jats:p>Tumour heterogeneity is a major barrier to cure breast cancer. It can exist between patients with different intrinsic subtypes of breast cancer or within an individual patient with breast cancer. In the latter case, heterogeneity has been observed between different metastatic sites, between metastatic sites and the original primary tumour, and even within a single tumour at either a metastatic or a primary site. Tumour heterogeneity is a function of two separate, although linked, processes. First, genetic instability is a hallmark of malignancy, and results in ‘fixed’ genetic changes that are almost certainly carried forward through progression of the cancer over time, with increasingly complex additional genetic changes in new metastases as they arise. The second type of heterogeneity is due to differential but ‘plastic’ expression of various genes important in the biology and response to various therapies. Together, these processes result in highly variable cancers with differential response, and resistance, to both targeted (e.g. endocrine or anti‐human epithelial growth receptor type 2 (<jats:styled-content style="fixed-case">HER</jats:styled-content>2) agents) and nontargeted therapies (e.g. chemotherapy). Ideally, tumour heterogeneity would be monitored over time, especially in relation to therapeutic strategies. However, biopsies of metastases require invasive and costly procedures, and biopsies of multiple metastases, or serially over time, are impractical. Circulating tumour cells (<jats:styled-content style="fixed-case">CTC</jats:styled-content>s) represent a potential surrogate for tissue‐based cancer and therefore might provide the opportunity to monitor serial changes in tumour biology. Recent advances have enabled accurate and reliable quantification and molecular characterization of <jats:styled-content style="fixed-case">CTC</jats:styled-content>s with regard to a number of important biomarkers including oestrogen receptor alpha and <jats:styled-content style="fixed-case">HER</jats:styled-content>2. Preliminary data have demonstrated that expression of these markers between <jats:styled-content style="fixed-case">CTC</jats:styled-content>s in individual patients with metastatic breast cancer reflects the heterogeneity of the underlying tumours. Future studies are designed to determine the clinical utility of these novel technologies in either research or routine clinical settings.</jats:p>
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spelling Hayes, D. F. Paoletti, C. 0954-6820 1365-2796 Wiley Internal Medicine http://dx.doi.org/10.1111/joim.12047 <jats:title>Abstract</jats:title><jats:p>Tumour heterogeneity is a major barrier to cure breast cancer. It can exist between patients with different intrinsic subtypes of breast cancer or within an individual patient with breast cancer. In the latter case, heterogeneity has been observed between different metastatic sites, between metastatic sites and the original primary tumour, and even within a single tumour at either a metastatic or a primary site. Tumour heterogeneity is a function of two separate, although linked, processes. First, genetic instability is a hallmark of malignancy, and results in ‘fixed’ genetic changes that are almost certainly carried forward through progression of the cancer over time, with increasingly complex additional genetic changes in new metastases as they arise. The second type of heterogeneity is due to differential but ‘plastic’ expression of various genes important in the biology and response to various therapies. Together, these processes result in highly variable cancers with differential response, and resistance, to both targeted (e.g. endocrine or anti‐human epithelial growth receptor type 2 (<jats:styled-content style="fixed-case">HER</jats:styled-content>2) agents) and nontargeted therapies (e.g. chemotherapy). Ideally, tumour heterogeneity would be monitored over time, especially in relation to therapeutic strategies. However, biopsies of metastases require invasive and costly procedures, and biopsies of multiple metastases, or serially over time, are impractical. Circulating tumour cells (<jats:styled-content style="fixed-case">CTC</jats:styled-content>s) represent a potential surrogate for tissue‐based cancer and therefore might provide the opportunity to monitor serial changes in tumour biology. Recent advances have enabled accurate and reliable quantification and molecular characterization of <jats:styled-content style="fixed-case">CTC</jats:styled-content>s with regard to a number of important biomarkers including oestrogen receptor alpha and <jats:styled-content style="fixed-case">HER</jats:styled-content>2. Preliminary data have demonstrated that expression of these markers between <jats:styled-content style="fixed-case">CTC</jats:styled-content>s in individual patients with metastatic breast cancer reflects the heterogeneity of the underlying tumours. Future studies are designed to determine the clinical utility of these novel technologies in either research or routine clinical settings.</jats:p> Circulating tumour cells: insights into tumour heterogeneity Journal of Internal Medicine
spellingShingle Hayes, D. F., Paoletti, C., Journal of Internal Medicine, Circulating tumour cells: insights into tumour heterogeneity, Internal Medicine
title Circulating tumour cells: insights into tumour heterogeneity
title_full Circulating tumour cells: insights into tumour heterogeneity
title_fullStr Circulating tumour cells: insights into tumour heterogeneity
title_full_unstemmed Circulating tumour cells: insights into tumour heterogeneity
title_short Circulating tumour cells: insights into tumour heterogeneity
title_sort circulating tumour cells: insights into tumour heterogeneity
title_unstemmed Circulating tumour cells: insights into tumour heterogeneity
topic Internal Medicine
url http://dx.doi.org/10.1111/joim.12047