An important observation by these authors was that they were able to detect these mutations in circulating tumor cells (CTCs) from the peripheral blood of 10 patients with either metastatic melanoma, breast, or colon cancer, suggesting that the Keap1-Nrf2-ARE cell survival pathway provides a survival advantage for these cells allowing them to form metastatic tumors in distant organs. This evidence concerns the gene KEAP1 and neoplasm.