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We previously demonstrated the feasibility of sCTC detection and genomic characterization in high\u2010grade serous ovarian cancer (HGSOC) by combining immune\u2010magnetic enrichment and image\u2010based sorting, followed by whole\u2010genome amplification (WGA) and next\u2010generation sequencing\u2010based copy number alteration analysis (CNA). Here we aimed to improve our workflow by incorporating HGSOC\u2010specific markers, folate receptor alpha (FR\u03b1), and markers to identify epithelial (cytokeratin) and mesenchymal (vimentin) phenotypes for the phenotypic as well as genotypic analysis of sCTCs over the course of treatment in 42 HGSOC patients. We detected a significant reduction of FR\u03b1\u2010positive cells (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.0205) and an expansion of cells with a high nuclear staining and no target antigen expression (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.002). Before treatment, sCTCs showed an enrichment in CNAs of Chromosomes 2, 7, and 12, while CNA dynamics of sCTCs suggested a potential selection of distinct CNAs specific to the homologous recombination pathway. sCTCs revealed persistent CNAs in the\n                    <jats:italic>CDK4<\/jats:italic>\n                    and emerging ones in the\n                    <jats:italic>ALK<\/jats:italic>\n                    oncogene. Notably, primary tumors revealed considerable fractions of shared genomic aberrations.\n                  <\/jats:p>","DOI":"10.1002\/1878-0261.70193","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T07:43:51Z","timestamp":1766562231000},"page":"1535-1555","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Phenotypic and genotypic characterization of single circulating tumor cells in the follow\u2010up of high\u2010grade serous ovarian cancer"],"prefix":"10.1002","volume":"20","author":[{"given":"Carolin","family":"Salmon","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics University Hospital Essen  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4515-739X","authenticated-orcid":false,"given":"Rui P. L.","family":"Neves","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Pediatric Surgery University Hospital and Medical Faculty of the Heinrich\u2010Heine University D\u00fcsseldorf  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3412-594X","authenticated-orcid":false,"given":"Nikolas H.","family":"Stoecklein","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Pediatric Surgery University Hospital and Medical Faculty of the Heinrich\u2010Heine University D\u00fcsseldorf  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven\u2010Thorsten","family":"Liffers","sequence":"additional","affiliation":[{"name":"West German Cancer Center, Bridge Institute of Experimental Tumor Therapy University Medicine Essen  Germany"},{"name":"Division of Solid Tumor Translational Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK) Partner Site Essen  69120 Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Siveke","sequence":"additional","affiliation":[{"name":"West German Cancer Center, Bridge Institute of Experimental Tumor Therapy University Medicine Essen  Germany"},{"name":"Division of Solid Tumor Translational Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK) Partner Site Essen  69120 Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3820-3017","authenticated-orcid":false,"given":"Jan D.","family":"Kuhlmann","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus Technische Universit\u00e4t Dresden  Dresden Germany"},{"name":"German Cancer Consortium (DKTK) Partner Site Dresden and German Cancer Research Center (DKFZ)  Heidelberg Germany"},{"name":"National Center for Tumor Diseases (NCT)  Dresden Germany"},{"name":"German Cancer Research Center (DKFZ)  Heidelberg Germany"},{"name":"Faculty of Medicine and University Hospital Carl Gustav Carus Technische Universit\u00e4t Dresden  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Wimberger","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus Technische Universit\u00e4t Dresden  Dresden Germany"},{"name":"German Cancer Consortium (DKTK) Partner Site Dresden and German Cancer Research Center (DKFZ)  Heidelberg Germany"},{"name":"National Center for Tumor Diseases (NCT)  Dresden Germany"},{"name":"German Cancer Research Center (DKFZ)  Heidelberg Germany"},{"name":"Faculty of Medicine and University Hospital Carl Gustav Carus Technische Universit\u00e4t Dresden  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