Liquid Biopsy in Colorectal Carcinoma: Clinical Applications and Challenges

Abstract

Colorectal carcinoma (CRC) is characterized by wide intratumor heterogeneity with general genomic instability and there is a need for improved diagnostic, prognostic, and therapeutic tools. The liquid biopsy provides a noninvasive route of sample collection for analysis of circulating tumor cells (CTCs) and genomic material, including cell-free DNA (cfDNA), as a complementary biopsy to the solid tumor tissue. The solid biopsy is critical for molecular characterization and diagnosis at the time of collection. The liquid biopsy has the advantage of longitudinal molecular characterization of the disease, which is crucial for precision medicine and patient-oriented treatment. In this review, we provide an overview of CRC and the different methodologies for the detection of CTCs and cfDNA, followed by a discussion on the potential clinical utility of the liquid biopsy in CRC patient care, and lastly, current challenges in the field.

<p>A Novel Prognostic Score Based on <em>ZG16</em> for Predicting CRC Survival</p>

“…Notably, CRC is characterized by extensive tumor heterogeneity and significant genomic instability, which influences greatly the treatment and prognosis of the patient. 8 , 9 Based on microarray technology and next-generation sequencing technology, aberrantly expressed genes and pathways have been identified in CRC. Furthermore, these genes are considered to be potential candidates for diagnosis or predicting survival of CRC patients.…”

Updates on liquid biopsy: current trends and future perspectives for clinical application in solid tumors

“…Colorectal cancer is a high prevalence malignant disease often diagnosed in late stage and with a severe impact on the population. Liquid biopsy approach to this disease could improve prognosis and quality of life [116]. CTCs have been investigated in colorectal cancer with different approaches, based on both physical properties of CTCs or marker expression [116].…”

“…Liquid biopsy approach to this disease could improve prognosis and quality of life [116]. CTCs have been investigated in colorectal cancer with different approaches, based on both physical properties of CTCs or marker expression [116]. From a clinical point of view, CTCs have been explored as biomarkers for screening, auxiliary staging of colorectal cancer, prognosis, monitoring drug resistance, and guiding medication as well as monitoring tools for minimal residual disease (MRD) [117].…”

The Liquid Biopsy in the Management of Colorectal Cancer: An Overview

“…Despite all the potential advantages of liquid biopsy in the management of CRC, there are still some practical issues that need to be addressed before it can be widely used in clinical practice [ 96 ]. Potential challenges may include low amounts of CTCs and ctDNA in samples, lack of pre-analytical and analytical consensus, clinical validation, regulatory endorsement and cost effectiveness [ 97 , 98 ]. Currently, the use of CTCs in routine diagnostics is limited, mainly due to methodological constraints, such as the lack of an established assessment practice, beyond enumeration [ 99 , 100 ].…”