Objective: Prostate cancer is the second commonest cause of cancer death in Australian men. While less fortunate individuals with aggressive disease will develop metastases and succumb to the disease; the majority of cases will lead a biologically indolent course. The identification and enumeration of circulating tumour cells (CTC) have shown potential in predicting prostate cancer outcomes. Together with increasing number of developments in CTC and cluster capturing devices, we have reached an exciting period where CTC and clusters might hold the answer for differentiating aggressive from indolent cases. We aim to review the current literature to provide an update on the utilisation of CTC and clusters in prostate cancer.
Methods: A systematic literature search of Medline/Pubmed and EMBASE was conducted up to August 2016. The search criteria included any studies with a title consisting of the terms circulating tumour cells, clusters and prostate.
Results: A total of 160 studies dating from October 1992 to August 2016 were identified.
Conclusion: CTC enumeration has been shown to be an accurate predictor in overall survival. Studies have also demonstrated that CTC counts can assist in determining response to therapy; therefore, addressing timing issues of switching to next-line therapeutic agents. Further developments in CTC and cluster isolation techniques have substantially reduced costs and increased accessibility. These techniques include centrifugation, microfiltration, immunomagnetic, dielectrophoresis and inertial focusing; methods which now enables capture of viable cells and clusters. This allows for further downstream analysis and culture; thus providing potential opportunities including genetic sequencing, early detection, assessing drug resistance and tracking of metastases.