Liquid biomarkers for the management of paediatric neuroblastoma: an approach to personalised and targeted cancer therapy

Abstract

Background: Neuroblastoma is the most common extracranial solid tumour of infancy and accounts for about 6–10% of paediatric cancers. It has a biologically and clinically heterogeneous behaviour that ranges from spontaneous regression to cases of highly aggressive metastatic disease that could be unresponsive to standard therapy. In recent years, there have been several investigations into the development of various diagnostic, predictive and prognostic biomarkers towards personalised and targeted management of the disease. Materials and Methods: This paper reports on the review of current clinical and emerging biomarkers used in risk assessment, screening for early detection and diagnosis, prognostication and monitoring of the response of treatment of neuroblastoma in paediatric patients. Conclusions: Tumour markers can significantly improve diagnosis; however, the invasive, unpleasant and inconvenient nature of current tissue biopsies limits their applications, especially in paediatric patients. Therefore, the development of a non-invasive, reliable high accurate and personalised diagnostic tool capable of early detection and rapid response is the most promising step towards advanced cancer management from tumour diagnosis, therapy to patient monitoring and represents an important step towards the promise of precision, personalised and targeted medicine. Liquid biopsy assay with wide ranges of clinical applications is emerging to hold incredible potential for advancing cancer treatment and has greater promise for diagnostic purposes, identification and tracking of tumour-specific alterations during the course of the disease and to guide therapeutic decisions.

A review of clinical and emerging biomarkers for breast cancers: towards precision medicine for patients

“…[46][47][48][49] The first account of the presence of CTCs in the peripheral blood was reported by Thomas Ashworth in 1869 in which he hypothesised that CTC cells might potentially offer better understanding of the metastatic process in cancer patients. [50][51][52][53] According to several studies, one major factor that contributes to cancer progression, relapse, poor survival and mortality in cancer patients is the metastatic tumours induced by the entry of CTC cells into the bloodstream or lymphatic vessels either as single cells or in clusters. 46,47,[54][55][56] The detection of CTC in blood has been reported in about 10-80% of breast cancer patients and it has been demonstrated to be correlated with tumour burden and are therefore more frequent in patients with metastatic breast disease.…”