ArticlePloS one2020
EpCAM-independent isolation of circulating tumor cells with epithelial-to-mesenchymal transition and cancer stem cell phenotypes using ApoStream® in patients with breast cancer treated with primary systemic therapy.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Circulating Tumor Cell Detection for Therapeutic and Prognostic Roles in Breast Cancer.Cancer medicine · 2025Pooled it
- Isolation and typing techniques for circulating tumor cells.Biomarker research · 2026Review
- Surface Marker Identification to Capture Live Circulating Tumor Cells in Metastatic Triple-Negative Breast Cancer.Cancer research communications · 2026Article
- Breast cancer stem cells and circulating tumor cells: Dual drivers of progression and relapse.World journal of stem cells · 2025Review
- Clinical applications of circulating tumor cells in metastasis and therapy.Journal of hematology & oncology · 2025Review
- Review
- Detection, significance and potential utility of circulating tumor cells in clinical practice in breast cancer (Review).Oncology letters · 2025Review
- Acoustic Enrichment of Heterogeneous Circulating Tumor Cells and Clusters from Metastatic Prostate Cancer Patients.Analytical chemistry · 2024Article
- Nanobiotechnology augmented cancer stem cell guided management of cancer: liquid-biopsy, imaging, and treatment.Journal of nanobiotechnology · 2024Review
- The expansion of liquid biopsies to vascular care: an overview of existing principles, techniques and potential applications to vascular malformation diagnostics.Frontiers in genetics · 2024Review
- Acoustic enrichment of heterogenous circulating tumor cells and clusters from patients with metastatic prostate cancer.medRxiv : the preprint server for health sciences · 2023Article
- Recent Advances in Methods for Circulating Tumor Cell Detection.International journal of molecular sciences · 2023Review
- Clinical Relevancy of Circulating Tumor Cells in Breast Cancer: Epithelial or Mesenchymal Characteristics, Single Cells or Clusters?International journal of molecular sciences · 2022Review
- Detection of circulating tumor cells: opportunities and challenges.Biomarker research · 2022Review
- Molecular and Circulating Biomarkers in Patients with Glioblastoma.International journal of molecular sciences · 2022Review
- Establishment of an optimized CTC detection model consisting of EpCAM, MUC1 and WT1 in epithelial ovarian cancer and its correlation with clinical characteristics.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2022Article
- Microfluidic-Based Technologies for CTC Isolation: A Review of 10 Years of Intense Efforts towards Liquid Biopsy.International journal of molecular sciences · 2022Review
- Relevance of Circulating Tumor Cells as Predictive Markers for Cancer Incidence and Relapse.Pharmaceuticals (Basel, Switzerland) · 2022Review
- Association of early changes of circulating cancer stem-like cells with survival among patients with metastatic breast cancer.Therapeutic advances in medical oncology · 2022Article
- Review
Corrections and comments
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Authors and funding
13 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundTumor cells with a mesenchymal phenotype and/or cancer stem-like cells (CSCs) are known to contribute to metastasis and drug resistance. Circulating tumor cells (CTCs) undergoing epithelial-mesenchymal transition (EMT) and CTCs reflecting a dedifferentiated CSC phenotype may not be detected using only an anti-EpCAM antibody to capture them. We used an antibody-independent CTC enrichment platform, ApoStream®, which does not rely on any antibody, including anti-EpCAM, to capture EMT- and CSC-CTCs in breast cancer patients who received neoadjuvant chemotherapy and correlated them to pathological complete response (pCR).
methodsBlood samples from newly diagnosed breast cancer patients were prospectively collected before neoadjuvant chemotherapy (T0), after chemotherapy but before surgery (T1), and after surgery (T2) and processed using ApoStream. CTCs detected were stained with additional markers to define 3 CTC subsets with the following phenotypes: epithelial CTCs (CK+, EpCAM+ or E-cadherin+), EMT-CTCs (β-catenin+ or vimentin+), and CSC-CTCs (CD44+ and CD24low).
resultsWe enrolled 55 patients, 47 of which had data for analysis. EMT-CTCs were detected in 57%, 62%, and 72% and CSC-CTCs in 9%, 22%, and 19% at the T0, T1, and T2 time points, respectively. Counts of epithelial (P = 0.225) and EMT (P = 0.522) phenotypes of CTCs at T0 did not significantly predict pCR. Moreover, no correlation between CTC count change and pCR was demonstrated.
conclusionsApoStream was successful in detecting EMT-CTCs among patients after neoadjuvant chemotherapy. However, EMT-/CSC-CTC counts did not correlate with pCR. Due to the small sample size and heterogeneity of this patient population, further study in a larger cohort of molecularly homogeneous patients is warranted.
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Registered trials
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