Journal
ANNALS OF ONCOLOGY
Volume 30, Issue 10, Pages 1580-1590Publisher
ELSEVIER
DOI: 10.1093/annonc/mdz227
Keywords
liquid biopsy; circulating free DNA; cancer diagnosis; resistance; minimal residual disease; clonal evolution
Categories
Funding
- European Community [602901 MErCuRIC]
- H2020 grant [635342-2 MoTriColor]
- IMI contract [115749 CANCER-ID]
- AIRC [16788, 21923]
- FONDAZIONE AIRC under 5 per Mille 2018 [21091]
- AIRC-CRUK-FC AECC Accelerator Award [22795]
- Ministero della Salute [NET-2011-02352137]
- Fondazione Piemontese per la Ricerca sul Cancro-ONLUS 5 per mille 2014 e 2015 Ministero della Salute
- Roche per la Ricerca grant 2017
- AIRC
- Asociacion Espanola contra el Cancer [GCTRA16015SEDA]
- FIS-ISCIII grant [PI16/01278]
- FERO-EDM support
- Cellex foundations
- Commonwealth Fund
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Cell-free DNA fragments are shed into the bloodstream by tumor cells. The analysis of circulating tumor DNA (ctDNA), commonly known as liquid biopsy, can be exploited for a variety of clinical applications. ctDNA is being used to genotype solid cancers non-invasively, to track tumor dynamics and to detect the emergence of drug resistance. In a few settings, liquid biopsies have already entered clinical practice. For example, ctDNA is used to guide treatment in a subset of lung cancers. In this review, we discuss how recent improvements in the sensitivity and accuracy of ctDNA analyses have led to unprecedented advances in this research field. We further consider what is required for the routine deployment of liquid biopsies in the clinical diagnostic space. We pinpoint technical hurdles that liquid biopsies have yet to overcome, including preanalytical and analytical challenges. We foresee how liquid biopsies will transform clinical practice: by complementing (or replacing) imaging to monitor treatment response and by detecting minimal residual disease after surgery with curative intent.
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