Liquid biopsy has become a key tool in translational oncology. While cfDNA analysis is already widely used, circulating tumor cells (CTCs) provide a more complex and informative sample. These cells are intact and viable, allowing real-time genomic, transcriptomic, proteomic, and functional analysis.<\/p>\n\n\n\n
However, their low frequency in peripheral blood (1\u201310 cells per mL) remains a major challenge. Therefore, efficient isolation technologies are required to preserve both structural and molecular integrity.<\/p>\n\n\n\n
The Parsortix\u00ae system addresses this need through an epitope-independent microfluidic approach. Specifically, it captures cells based on physical properties, enabling viable recovery and downstream analysis.<\/p>\n\n\n\n
From a biological perspective, CTCs offer several advantages over ctDNA. First, they provide intact tumor cells. In addition, they enable single-cell analysis. Moreover, they allow simultaneous evaluation of DNA, RNA, and proteins. As a result, they support detailed clonal and functional characterization.<\/p>\n\n\n\n
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In 2025, an international panel of experts published a structured consensus in European Journal of Cancer<\/em> on the clinical integration of CTCs in solid tumors.<\/p>\n\n\n\n The conclusions establish that:<\/p>\n\n\n\n \u2022 There is sufficient evidence for the clinical use of CTCs in metastatic disease, particularly in breast and prostate cancer. This consensus consolidates the clinical validity of CTCs in advanced disease and establishes a conceptual framework oriented toward molecular and functional characterization as the next evolutionary step.<\/p>\n\n\n\n <\/p>\n\n\n\n The technological architecture of Parsortix aligns with this approach by prioritizing the recovery of intact and analytically exploitable cells.<\/p>\n\n\n\n Parsortix is based on separation by size and deformability. The microfluidic cassette incorporates a progressive reduction of the channel until reaching a \u201ccritical gap,\u201d where hematologic cells pass through the system while tumor cells\u2014generally larger and less deformable\u2014are retained.<\/p>\n\n\n\n This approach is particularly relevant in the context of tumor heterogeneity.<\/p>\n\n\n\n <\/p>\n\n\n\n CTCs do not constitute a uniform population. During processes such as epithelial\u2013mesenchymal transition (EMT), they may lose classical epithelial markers and acquire mesenchymal or hybrid phenotypes.<\/p>\n\n\n\n Epitope-independent capture enables the recovery of:<\/p>\n\n\n\n \u2022 epithelial CTCs Thus, preserving the phenotypic and potentially functional diversity of the circulating population.<\/p>\n\n\n\n <\/p>\n\n\n\n The international consensus highlights a conceptual transition:<\/p>\n\n\n\n \u2022 In current practice, CTC enumeration has validated prognostic utility in metastatic disease. From a biological perspective, CTCs offer differential advantages over ctDNA:<\/p>\n\n\n\n \u2022 cellular tumor material By enabling the recovery of viable cells, Parsortix facilitates the transition from quantitative detection to integrated multi-omic characterization.<\/p>\n\n\n\n <\/p>\n\n\n\n The consensus emphasizes that CTCs and ctDNA represent biologically complementary analytes.<\/p>\n\n\n\n ctDNA reflects DNA fragments released into the bloodstream, mainly derived from tumor apoptosis or necrosis. The integration of both analytes can:<\/p>\n\n\n\n \u2022 increase sensitivity in minimal residual disease (MRD) Parsortix enables this multimodal model through:<\/p>\n\n\n\n \u2022 plasma separation for cfDNA analysis <\/p>\n\n\n\n In non-metastatic disease, the consensus recognizes that clinical utility is not yet established, although strong biological validity exists, especially in early breast cancer.<\/p>\n\n\n\n Main limitations include:<\/p>\n\n\n\n \u2022 low CTC frequency The development of prospective multicenter studies and methodological harmonization will be key to translating biological validity into demonstrated clinical utility.<\/p>\n\n\n\n <\/p>\n\n\n\n The consensus defines the following priorities:<\/p>\n\n\n\n \u2022 standardization of pre-analytical and analytical protocols In this context, cell capture represents only the initial phase of the analytical process. The ultimate goal is to obtain biologically relevant information with functional and translational value.<\/p>\n\n\n\n In this scenario, Parsortix is not merely a cell enrichment technology, but an analytical platform that integrates capture, viability, and multi-omic characterization within a single experimental workflow, expanding the biological scope of liquid biopsy.<\/p>\n","protected":false},"excerpt":{"rendered":" Liquid biopsy has become a key tool in translational oncology. While cfDNA analysis is already widely used, circulating tumor cells (CTCs) provide a more complex and informative sample. These cells are intact and viable, allowing real-time genomic, transcriptomic, proteomic, and functional analysis. However, their low frequency in peripheral blood (1\u201310 cells per mL) remains a …<\/p>\n","protected":false},"author":13,"featured_media":3280,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[36,35],"tags":[],"class_list":["post-3279","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biomedicine","category-biopsy"],"acf":[],"yoast_head":"\n
\u2022 Enumeration constitutes a validated prognostic biomarker in this context.
\u2022 The next stage of clinical development should focus on phenotypic and molecular characterization.
\u2022 Integration with ctDNA represents a strategic axis for field advancement.
\u2022 Antigen-independent technologies gain relevance within this transition.<\/p>\n\n\n\nMicrofluidic capture based on size and deformability<\/h2>\n\n\n\n
Tumor heterogeneity and epithelial\u2013mesenchymal transition (EMT)<\/h2>\n\n\n\n
\u2022 mesenchymal CTCs
\u2022 intermediate EMT states
\u2022 tumor cell clusters<\/p>\n\n\n\nFrom prognostic biomarker to therapeutic stratification tool<\/h2>\n\n\n\n
\u2022 In future development, molecular and proteomic characterization will be critical for response prediction and therapy selection.
\u2022 The evaluation of biomarkers such as HER2, TROP2, PD-L1, PSMA, or c-MET in CTCs is identified as a priority line for advancing toward personalized medicine models.<\/p>\n\n\n\n
\u2022 single-cell analysis capability
\u2022 simultaneous DNA, RNA, and protein evaluation
\u2022 clonal and subclonal characterization
\u2022 potential for functional studies<\/p>\n\n\n\nBiological complementarity with ctDNA<\/h2>\n\n\n\n
In contrast, CTCs are intact cells with preserved architecture and full biological context.<\/p>\n\n\n\n
\u2022 refine prognostic models
\u2022 expand the proportion of evaluable patients
\u2022 provide non-overlapping biological information<\/p>\n\n\n\n
\u2022 subsequent cellular capture within the same workflow
\u2022 downstream molecular and proteomic analysis<\/p>\n\n\n\nEarly disease and MRD monitoring<\/h2>\n\n\n\n
\u2022 pre-analytical and analytical variability
\u2022 need for greater sensitivity and reproducibility<\/p>\n\n\n\nAlignment with strategic priorities in the field<\/h2>\n\n\n\n
\u2022 structured integration with ctDNA
\u2022 characterization of key therapeutic biomarkers
\u2022 generation of robust clinical evidence
\u2022 design of biomarker-driven prospective trials<\/p>\n\n\n\n