Potential Utility of Liquid Biopsy as a Diagnostic and Prognostic Tool for the Assessment of Solid Tumors: Implications in the Precision Oncology

Abstract

Liquid biopsy is a technique that utilizes circulating biomarkers in the body fluids of cancer patients to provide information regarding the genetic landscape of the cancer. It is emerging as an alternative and complementary diagnostic and prognostic tool to surgical biopsy in oncology. Liquid biopsy focuses on the detection and isolation of circulating tumor cells, circulating tumor DNA and exosomes, as a source of genomic and proteomic information in cancer patients. Liquid biopsy is expected to provide the necessary acceleratory force for the implementation of precision oncology in clinical settings by contributing an enhanced understanding of tumor heterogeneity and permitting the dynamic monitoring of treatment responses and genomic variations. However, widespread implementation of liquid biopsy based biomarker-driven therapy in the clinical practice is still in its infancy. Technological advancements have resolved many of the hurdles faced in the liquid biopsy methodologies but sufficient clinical and technical validation for specificity and sensitivity has not yet been attained for routine clinical implementation. This article provides a comprehensive review of the clinical utility of liquid biopsy and its effectiveness as an important diagnostic and prognostic tool in colorectal, breast, hepatocellular, gastric and lung carcinomas which were the five leading cancer related mortalities in 2018.

Diagnostic and prognostic value of preoperative systemic inflammatory markers in anaplastic thyroid cancer

“…By now, the pathological examination through fine needle aspiration or core needle biopsy is considered as the gold standard of diagnosis of ATC, but it usually takes at least a few days to obtain the pathology report, and it lacks specific biomarkers, which also barricades pathologists to draw conclusion 2 . Recently, liquid biopsy provides novel approaches to quickly diagnose solid tumors by detecting the circulating tumors cells, cell‐free DNA, and tumor‐derived exosomes in peripheral blood, but it is extremely limited by expensive cost and dependence of lab apparatus 8,9 . Thus, a quick, reliable and affordable method of discrimination is expected to tailor management for patients with ATC.…”

Unearthing EGFR Mutations and the Rewards of Persistence in Precision Oncology: Breaching the 10-Year Survival Barrier in Metastatic NSCLC With Active Disease

“…NGS can be applied on both liquid biopsy samples as well as tissue specimens. 4,5 In both our patients, EGFRm was either not demonstrable or was proven to be negative by the currently recommended FDA-approved methods. But given the clinical profile of our patients (nonsmokers) and limited therapeutic options after conventional chemotherapy, repeated attempts were made to detect targetable mutations.…”

Tissue factor activity on microvesicles from cancer patients

“…Shown is the mean ± SD; n = 28; ****p < 0.0001 cells (Van Niel et al 2018). Therefore, in principle, they could be used as liquid biopsies in the diagnosis of cancer (Ender et al 2019;Mathai et al 2019).…”