Liquid biopsy of cancer: a multimodal diagnostic tool in clinical oncology

Abstract

Over the last decades, the concept of precision medicine has dramatically renewed the field of medical oncology; the introduction of patient-tailored therapies has significantly improved all measurable outcomes. Liquid biopsy is a revolutionary technique that is opening previously unexpected perspectives. It consists of the detection and isolation of circulating tumor cells, circulating tumor DNA and exosomes, as a source of genomic and proteomic information in patients with cancer. Many technical hurdles have been resolved thanks to newly developed techniques and next-generation sequencing analyses, allowing a broad application of liquid biopsy in a wide range of settings. Initially correlated to prognosis, liquid biopsy data are now being studied for cancer diagnosis, hopefully including screenings, and most importantly for the prediction of response or resistance to given treatments. In particular, the identification of specific mutations in target genes can aid in therapeutic decisions, both in the appropriateness of treatment and in the advanced identification of secondary resistance, aiming to early diagnose disease progression. Still application is far from reality but ongoing research is leading the way to a new era in oncology. This review summarizes the main techniques and applications of liquid biopsy in cancer.

<p>Exploring Metabolic Consequences of<em> CPS1</em> and<em> CAD</em> Dysregulation in Hepatocellular Carcinoma by Network Reconstruction</p>

“…2,32 Although research has been conducted to link specific mutations to individual etiologies in HCC, the extent of the findings from such research has been minimal. 33 Methodology established by this study can be extended to determine whether the concentrations of any metabolite from the network differed in any underlying etiologies of HCC, which could allow conclusions to be reached regarding the role of specific genes such as CPS1 and CAD in different etiologies of HCC.…”

Emerging Role of Circulating Tumor Cells in Gastric Cancer

“…However, those biomarkers display less than 40% positivity rates, and their sensitivities and specificities are modest [5,6]. In this regard, circulating tumor cells (CTCs) emerge as promising markers to monitor treatment responses and to provide progression information in a real-time manner [7][8][9][10].…”

Laser‐driven radiation: Biomarkers for molecular imaging of high dose‐rate effects

“…Some can be identified by “systems medicine” tools for minimally invasive screening in blood. New perspectives for accurate investigation of cancer‐related biomarkers are now provided by liquid biopsy, which allows isolation of circulating tumor cells, tumor DNA, and exosomes, as a rich and more specific source of genomic and proteomic information for cancer patients . The technological advance brought by next‐generation sequencing (NGS) for DNA and, more recently, RNA, supports high‐throughput evaluation of single‐nucleotide polymorphisms (SNPs) and accurate prognosis of radiotherapy outcome …”

“…New perspectives for accurate investigation of cancer-related biomarkers are now provided by liquid biopsy, which allows isolation of circulating tumor cells, tumor DNA, and exosomes, as a rich and more specific source of genomic and proteomic information for cancer patients. 15 The technological advance Medical Physics, 46 (10), October 2019 brought by next-generation sequencing (NGS) for DNA and, more recently, RNA, supports high-throughput evaluation of single-nucleotide polymorphisms (SNPs) and accurate prognosis of radiotherapy outcome. 16,17 UV-Vis or fluorescent spectroscopic methods for the detection of biomarkers 18 rely on the availability of molecules featuring chromophores or the introduction of biocompatible molecules bearing chromophores.…”