Circulating tumor cells (CTC) present in peripheral blood are assigned precursors of advanced tumor disease. Simplicity of blood withdrawal procedure adds practically an unlimited possibility of the CTC-monitoring and the advantages of the repeated biopsies over time. CTC got prognostic, predictive and diagnostic status with the technologic advance. Although the clinical utility of CTC has reached the high evidence, the significance of CTC testing was presented in the treatment strategy mostly with palliative intention. We report on the experiences with the CTC-testing in the CLIA-like laboratory working with the size-based CTC separation and in vitro culture. The data is presented in the form of case reports in patients with breast (BC), colorectal (CRC), prostate (PC) and lung cancer (NSCLC) to support the clinical utility of CTC during the neoadjuvant, adjuvant and palliative treatment. The presented findings support the evidence for liquid biopsy clinical implementation and enhance the ability of malignant disease monitoring and the treatment efficacy prediction.

3rd Department of Surgery 1st Faculty of Medicine Charles University Prague and University Hospital MotolPrague 5 Uvalu 84 15006 Prague

Department of Laboratory Genetics University Hospital Kralovske Vinohrady Srobarova 5010034 Prague Czech Republic

Department of Oncology 1st Faculty of Medicine Charles University and General University Hospital Prague U Nemocnice 499 212808 Prague Czech Republic

Department of Thoracic Surgery Masaryk's Hospital in Usti nad Labem Krajska Zdravotni a s Socialni Pece 3316 12A40113 Usti nad Labem Czech Republic

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Circulating Tumor Cells in Diagnosis and Treatment of Lung Cancer