Strategies of mechanical adaptations of circulating tumor cells and properties of their cellular microenvironment have predictive and prognostic biomarker value

Live circulating tumor cells from peripheral blood of prostate cancer patients show distinct mechanical fitness strategies, including erythrocyte-like stiffness, leukocyte-like deformability, and exceptionally high-adhesion clustering.

• Why it matters: Blood shear mechanically damages most tumor-shed CTCs, so identifying fitness-linked adaptations and their microenvironmental context is needed for predictive and prognostic biomarkers.
• What they did: Using atomic force spectroscopy based force spectrometry, the study mechanophenotyped live CTCs and quantified adhesion clustering, then tested predictive value during androgen deprivation and stratification of recurrent patients using PSMA-PET/CT.
• The result: Elevated-adhesion CTCs predict prostate cancer patients starting first round of androgen deprivation therapy, and adhesion scores stratify recurrent cases with inconclusive PSMA scans; adding CTC microenvironment composition improves prediction of early castration resistance.

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