Circulating tumor DNA detection in MRD assessment and diagnosis and treatment of non-small cell lung cancer

Abstract

Circulating tumor DNA (ctDNA) has contributed immensely to the management of hematologic malignancy and is now considered a valuable detection tool for solid tumors. ctDNA can reflect the real-time tumor burden and be utilized for analyzing specific cancer mutations via liquid biopsy which is a non-invasive procedure that can be used with a relatively high frequency. Thus, many clinicians use ctDNA to assess minimal residual disease (MRD) and it serves as a prognostic and predictive biomarker for cancer therapy, especially for non-small cell lung cancer (NSCLC). Advanced methods have been developed to detect ctDNA, and recent clinical trials have shown the rationality and feasibility of ctDNA for identifying mutations and guiding treatments in NSCLC. Here, we have reviewed recently developed ctDNA detection methods and the importance of sequence analyses of ctDNA in NSCLC.

The Role of Cell-Free DNA in Cancer Treatment Decision Making

“…The half-life of cfDNA is short; consequently, it may be appropriate for monitoring the current tumor burden in response to therapy. In fact, the plasma half-life of the circulating cfDNA including ctDNA is between 16 min and 2.5 h. Thus, liquid biopsies seem to allow real-time monitoring of the tumor burden [ 186 ]. This would be a great advantage since the serum half-life of standard tumor markers such as CA-125 and CEA is days or weeks [ 37 ].…”

Ribonucleotide reductase regulatory subunit M2 (RRM2) as a potential sero-diagnostic biomarker in non-small cell lung cancer

“…Unfortunately, traditional tumor markers, such as cytokeratin fragment 21-1 (CYFRA21-1), pro-gastrin-releasing peptide (ProGRP), carcinoembryonic antigen (CEA), and neuron-specific enolase (NSE), are limited in clinical use due to their poor sensitivity and specificity values [6][7][8]. Notably, several novel biomarkers for the diagnosis of NSCLC have been identified in recent years due to their higher sensitivity and specificity compared to traditional tumor markers, including exosomes [9,10], circulating tumor DNA (ctDNA) [11,12], microRNAs [13], CircRNAs [14], and long non-coding RNA [15,16]. However, there are still many challenges associated with their widespread use in population screening, including restrictive detection technology, equipment complexity, and high testing costs.…”