Perspective on circulating tumor cell clusters: Why it takes a village to metastasize

Mario Giuliano, Anum Shaikh, Hin Ching Lo, Grazia Arpino, Sabino De Placido, Xiang H. Zhang, Massimo Cristofanilli, Rachel Schiff, Meghana V. Trivedi*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

145 Scopus citations


Circulating tumor cell (CTC) clusters May represent one of the key mechanisms initiating the metastasis process. However, the series of pathophysiologic events by which CTC clusters originate, enter the circulation, and reach the distant sites remain to be identified. The cellular and molecular mechanisms that provide survival advantage for CTC clusters during the transit in the blood stream are also still largely unknown. Understanding the biology of CTC clusters is critical to assess this unified scheme employed by cancer and to device strategies to overcome key pathways responsible for their improved metastatic potential. CTC clusters remain an underdeveloped area of research begging the attention of multidisciplinary cancer research teams. Here, we provide insight on existing preclinical evidence on the potential mechanisms leading to CTC cluster formation and dissemination and on processes that May offer survival advantage. We also offer our perspective on future directions to delineate the role of CTC clusters in metastatic cascade and discuss their clinical significance.

Original languageEnglish (US)
Pages (from-to)845-852
Number of pages8
JournalCancer Research
Issue number4
StatePublished - Feb 15 2018

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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