circulating tumor cell clusters

Another form of non-EMT-associated dissemination, which is thought to substantially contribute to metastasis, is the release of "circulating tumor cell clusters" (Aceto et al, 2014).

These clusters are constituted of 2–50 tumor cells held together by plakoglobin-dependent intercellular adhesion.

Clustered cells are less likely to undergo anoikis and have an increased likelihood of being trapped in narrow blood vessels, thus favoring extravasation into distant organs.