肿瘤转移是癌症进展的顶峰，对治疗工作提出了巨大的挑战。循环肿瘤细胞（CTC）是源自原发肿瘤或其转移瘤的弹性实体，通过表现出卓越的适应性，为这一过程做出了重大贡献。它们能够承受剪切应力、抵抗失巢凋亡、逃避免疫监视并阻止化疗。这篇全面的综述旨在阐明 CTC 形成的复杂情况、转移机制以及影响其行为的众多因素。详细检查了整合素相关信号传导、细胞自噬、上皮-间质转化以及与血小板的相互作用等整合信号传导途径。此外，我们探索精密纳米医学设计领域，特别强调失巢凋亡-血小板界面。这种创新方法战略性地针对 CTC 生存机制，为以前所未有的精度和功效对抗转移性癌症提供了有前景的途径。该综述强调了基于血小板的纳米药物的合理设计在抑制 CTC 驱动的转移中不可或缺的作用。© 2024 作者。

Tumor metastasis, the apex of cancer progression, poses a formidable challenge in therapeutic endeavors. Circulating tumor cells (CTCs), resilient entities originating from primary tumors or their metastases, significantly contribute to this process by demonstrating remarkable adaptability. They survive shear stress, resist anoikis, evade immune surveillance, and thwart chemotherapy. This comprehensive review aims to elucidate the intricate landscape of CTC formation, metastatic mechanisms, and the myriad factors influencing their behavior. Integral signaling pathways, such as integrin-related signaling, cellular autophagy, epithelial-mesenchymal transition, and interactions with platelets, are examined in detail. Furthermore, we explore the realm of precision nanomedicine design, with a specific emphasis on the anoikis‒platelet interface. This innovative approach strategically targets CTC survival mechanisms, offering promising avenues for combatting metastatic cancer with unprecedented precision and efficacy. The review underscores the indispensable role of the rational design of platelet-based nanomedicine in the pursuit of restraining CTC-driven metastasis.© 2024 The Authors.