Liquid Biopsy: A New Translational Diagnostic and Monitoring Tool for Musculoskeletal Tumors

Abstract

Soft tissue and bone sarcomas represent a group of aggressive neoplasms often accompanied by dismal patient prognosis, especially when distant metastases are present. Moreover, effective treatment can pose a challenge, as recurrences are frequent and almost half of patients present with advanced disease. Researchers have unveiled the molecular abnormalities implicated in sarcomas’ carcinogenesis, paving the way for novel treatment strategies based on each individual tumor’s characteristics. Therefore, the development of new techniques aiding in early disease detection and tumor molecular profiling is imperative. Liquid biopsy refers to the sampling and analysis of patients’ fluids, such as blood, to identify tumor biomarkers, through a variety of methods, including qRT-PCR, qPCR, droplet digital PCR, magnetic microbeads and digital PCR. Assessment of circulating tumor cells (CTCs), circulating free DNA (ctDNA), micro RNAs (miRs), long non-coding RNAs (lncRNAs), exosomes and exosome–associated proteins can yield a plethora of information on tumor molecular signature, histologic type and disease stage. In addition, the minimal invasiveness of the procedure renders possible its wide application in the clinical setting, and, therefore, the early detection of the presence of tumors. In this review of the literature, we gathered information on biomarkers assessed through liquid biopsy in soft tissue and bone sarcoma patients and we present the information they can yield for each individual tumor type.

Application of Indocyanine Green Fluorescence Imaging in Assisting Biopsy of Musculoskeletal Tumors

“…In the study of biopsy of bone and soft tissue tumors, although many researchers used different methods to improve the positive rate of biopsy, such as PET-CT-guided biopsy [ 28 ] and liquid biopsy [ 29 ], and the positive rate of biopsy has increased significantly, there is still a risk of biopsy failure. Even with the most advanced and accurate CT navigation or B-mode ultrasound equipment, a 100% success rate and diagnostic accuracy of core biopsy cannot be guaranteed.…”

Angiogenesis in gastrointestinal stromal tumors: From bench to bedside

“…The development of biomarkers comprises an essential step towards the individualization of medical practice. Liquid biopsy provides a cutting-edge, non-invasive technology to access predictive information to guide the therapeutic management in a wide variety of diseases[ 47 - 51 ]. It’s application in GIST treatment has been started to emerge[ 52 , 53 ].…”

Exosomes in the Treatment of Pancreatic Cancer: A Moonshot to PDAC Treatment?

“…Similarly, the participation of exosomes in cancer pathophysiology with applications in diagnosis, prognosis, and treatment has been extensively studied [ 57 , 58 , 59 ].…”