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.