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The entity of circulating tumor cells becomes more and more important and attracts the scientific interest due to their involvement in tumor metastases.The new entity of tumor initiating cells is also start to attract the same interest for the same reasons.The two entities are overlapping and may become a possible tool for prognosis, and treatment decision under personalized concept.The biochemical pathways that are responsible to stemness properties are more easily to be analyzed through the CTCs instead of the primary tissue sample and the understanding of the tumor biology reveals that even the stemness features involve the pleomorphy and dynamic mechanism.This means that there are many kinds of tumor initiating cells in every case and it is essential to understand the pathways that are involved on developing stemness properties in cancer cells.