We were looking for a new biomarker to predict tumor response in lung cancer. We have measured circulating tumor cells (CTCs) during surgery and identified more of them in the pulmonary vein compared to the radial artery. This suggests a central clearance of CTC, perhaps in the heart.
We were interested in the pathophysiology of released CTCs in early lung cancer because CTCs are strong prognostic markers for lung cancer. We discovered that indeed these cells are markers for lung cancer prognosis, but are not markers for prediction, since they are mainly released close to the primary tumor, not in the peripheral circulation. The reason was a central clearance and not a peripheral clearance in the microcirculation.
We expected that, next to the strong prognostic role, CTCs would also be important predictive factors that could be used in clinical practice. Nowadays other biomarkers are evolving such as circulating tumor DNA.
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