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Liquid Biopsy in oncology - current achievements and new challenges

In the era of precision oncology decisions about treatment of cancer patients are often being based on genetic and other specific characteristics of particular cancer in a particular patient. To analyze these characteristic we need to obtain cancer tissue sample through tissue biopsy which is often invasive, risky and painful procedure. Furthermore due to cancer clonal evolution and heterogeneity biopsy samples from one lesion (primary cancer or metastasis) might not be relevant and representative for other cancer lesions in the same patient. Potential solution for these problems is liquid biopsy where cancer characteristics are determined by analysis of bodily fluids, most often blood. It was shown that circulating tumor cells (CTC), circulating cell- free tumor DNA (ctDNA) and circulating cancer exosomes can be detected and characterized in blood samples from cancer patients. Many recently published studies have shown potential clinical utility of liquid biopsy for early cancer detection, making decisions about treatment, monitoring treatment response, and predicting patient prognosis in different types of cancer. However, there are some technical, clinical, and biological challenges that need to be addressed before liquid biopsy tests become routine standardized procedures for cancer patients. So far, one ctDNA based liquid biopsy test was approved by U.S. Food and Drug Administration in 2016 for detecting EGFR mutations in patients with lung cancer.

liquid biopsy ; cancer ; circulating tumor cells ; exosomes ; cell-free tumor DNA

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