Liquid Biopsy in Pancreatic Cancer: Are We Ready to Apply It in the Clinical Practice?

Abstract

Simple SummaryPancreatic ductal adenocarcinoma (PDAC) is one of the tumors with the highest mortality, for which survival has hardly changed in the last 40 years. This high mortality is due to the lack of tests that would allow an early diagnosis and the fact that current treatments are not very effective. Liquid biopsy (LB) represents an interesting tool that can help in early diagnosis, treatment selection, disease monitoring, evaluation of the response and prognosis. It is a minimally invasive and risk-free procedure that can detect both the presence of genetic material from the tumor and circulating tumor cells (CTCs) in the blood and in other bodily fluids, and therefore distantly reflect the global status of the disease.Pancreatic ductal adenocarcinoma (PDAC) exhibits the poorest prognosis of all solid tumors, with a 5-year survival of less than 10%. To improve the prognosis, it is necessary to advance in the development of tools that help us in the early diagnosis, treatment selection, disease monitoring, evaluation of the response and prognosis. Liquid biopsy (LB), in its different modalities, represents a particularly interesting tool for these purposes, since it is a minimally invasive and risk-free procedure that can detect both the presence of genetic material from the tumor and circulating tumor cells (CTCs) in the blood and therefore distantly reflect the global status of the disease. In this work we review the current status of the main LB modalities (ctDNA, exosomes, CTCs and cfRNAs) for detecting and monitoring PDAC.