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Circulating tumor cells versus tumor-derived cell-free DNA: rivals or partners in cancer care in the era of single-cell analysis?

Evelyn Kidess12 and Stefanie S Jeffrey1*

Author Affiliations

1 Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA

2 Department of Surgery, Charité University Hospital, 12203 Berlin, Germany

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Genome Medicine 2013, 5:70  doi:10.1186/gm474

Published: 13 August 2013

First paragraph (this article has no abstract)

Cancer presents a problem of complexity. Although our understanding of tumor biology has increased exponentially over recent decades, and we have many available technologies to characterize tumors, whether and when an individual cancer will metastasize remains unknown. Moreover, if metastases do occur, their molecular features may not match those of the primary tumor or other metastases. Ideally, to guide treatment decisions, all micro- and macrometastases would be identified, biopsied and molecularly analyzed, but this is not currently possible, practical or safe. Thus, investigations are now focusing on blood-based assays that detect and characterize circulating tumor cells or circulating tumor DNA (a component of cell-free DNA). These minimally invasive, real-time 'liquid biopsies' can be performed at multiple intervals to monitor disease and tailor cancer therapy. It is as yet unknown whether these represent competing technologies or if they should be used together.