Abstract
Liquid biopsy in endometrial cancer
Highlights
The current use of traditional biopsy in the management of cancer has several limitations in the developing era of precision medicine, with cancer treatment mainly due to the progression of cancer and the onset of resistance to therapies
Concerning Endometrial cancer (EC), no studies have been reported comparing circulating tumor cells (CTCs), but an interesting study compares the somatic mutation profile evaluated on circulating tumor DNA (ctDNA) extracted from plasma to that derived from peritoneal lavage on 50 patients by Next Generation Sequencing technologies (NGS), which shows a concordance on KRAS of 42% between primary tissue and peritoneal lavage ctDNA and 18% for PIK3CA; for plasma ctDNA, this concordance decreases to 7% and 4%, respectively[16]
In 2013, the Cancer Genome Atlas Research Network (TCGA) suggested implementing a classification with molecular characterization[10], which can be useful to define targeted therapy and monitor cancer development and treatment; today, there are no targeted therapies: there is no molecular target for treatment, detection, or monitoring[11]
Summary
The current use of traditional biopsy in the management of cancer has several limitations in the developing era of precision medicine, with cancer treatment mainly due to the progression of cancer and the onset of resistance to therapies. Blood circulating biomarkers are currently used in research and have been suggested for tumor characterization to set a personalized target therapy [e.g., epidermal growth factor receptor (EGFR) mutation profile in lung carcinoma] in clinical practice. The incidence has increased between 1980 and 2010, due to an increment in average age and obesity[7] Eighty percent of this type of cancer is diagnosed in an early stage [by International Federation of Gynecology and Obstetrics (FIGO) 2009 classification: stage IA], with five-year survival rates above 80%. In 2013, the Cancer Genome Atlas Research Network (TCGA) suggested implementing classification based on molecular characterization[10], which can be useful to define targeted therapy and monitor cancer development and treatment. We investigate the classical biomarkers in blood LB and the new ones in other biofluids for EC [Table 1] by reviewing the data in journal databases
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