Table 1. Comparison of circulating tumor cells and circulating-tumor DNA platforms.
Advantages | Disadvantages | |
---|---|---|
Circulating tumor DNA | ctDNA is easier to isolate; long-term storage for subsequent analysis feasible; analysis with real-time PCR or digital PCR for known point mutations and very low allele fractions, or targeted deep sequencing | Limited pre-analytical/analytical assay validation with some platforms; short fragment DNA from necrotic or apoptotic cancer cells; limited possibilities for downstream analysis (DNA only) |
Circulating tumor cells | Evaluation of intact cancer cells is invaluable for downstream analyses allowing interrogation of the DNA, RNA or at the protein level; some CTC live cell isolation platforms can allow ex-vivo expansion and creating in-vitro and patient-derived xenograft models to investigate drug susceptibility and allow deeper understanding the molecular profiles; single-cell analysis technologies allow for new insights into the genetic make-up of CTCs | Complex detection and enrichment steps required and often require sophisticated technologies; low CTC numbers in non-metastatic and low disease burden settings |