Figure 2.

Muc4 mediates CTC survival in circulation. Muc4-positive CTCs form pro-survival cell aggregates with blood-borne cells during vascular transit, enabling them to more efficiently seed metastatic lesions at distant organs. On the other hand, Muc4-negative CTCs fail to survive the harsh conditions of transit, succumbing to shear forces and undergoing anoikis. These cells are unable to form CTC-blood cell aggregates, impairing their ability to successfully colonize metastatic lesions (Rowson-Hodel et al., 2018).