Abstract
One in every four deaths is due to cancer in Europe. In view of its increasing incidence, cancer became the leading cause of death and disease burden in Denmark, France, the Netherlands, and the UK. Without essential improvements in cancer prevention, an additional 775,000 cases of annual incidence have been prognosed until 2040. Between 1995 and 2018, the direct costs of cancer doubled from EUR 52 billion to EUR 103 billion in Europe, and per capita health spending on cancer increased by 86% from EUR 105 to EUR 195 in general, whereby Austria, Germany, Switzerland, Benelux, and France spend the most on cancer care compared to other European countries. In view of the consequent severe socio-economic burden on society, the paradigm change from a reactive to a predictive, preventive, and personalized medical approach in the overall cancer management is essential. Concepts of predictive, preventive, and personalized medicine (3PM) demonstrate a great potential to revise the above presented trends and to implement cost-effective healthcare that benefits the patient and society as a whole. At any stage, application of early and predictive diagnostics, targeted prevention, and personalization of medical services are basic pillars making 3PM particularly attractive for the patients as well as ethical and cost-effective healthcare. Optimal 3PM approach requires novel instruments such as well-designed liquid biopsy application. This review article highlights current achievements and details liquid biopsy approaches specifically in cancer management. 3PM-relevant expert recommendations are provided.
Highlights
According to current statistics provided by the World Health Organization, one out of six deaths is due to cancer worldwide, demonstrating the annual mortality rate at a level of 10 million [1]
Considering the importance of human papilloma viral (HPV) DNA in saliva for HPV-associated oropharyngeal cancer (HPV-OPC), an acoustofluidic platform has been developed in order to isolate salivary exosomes, which are hypothesized to be packaged with HPV-associated biomarkers for salivary exosome-based liquid biopsy
extracellular vesicles (EVs)-based liquid biopsy for EGFR genotyping using bronchoalveolar lavage fluid obtained from tumor sites has been related to highly accurate diagnosis of lung cancer patients, which is associated with the content of double-stranded DNA in EVs that reflects the mutational status of parental cancer cells in non-small cell lung cancer (NSCLC) [153]
Summary
According to current statistics provided by the World Health Organization, one out of six deaths is due to cancer worldwide, demonstrating the annual mortality rate at a level of 10 million [1]. According to the comparator report on cancer in Europe 2019 (disease burden, costs and access to medicines), there will be an additional 775,000 cases of annual incidence until 2040 without improvements in cancer prevention [2]. The most common cancer types worldwide are lung (2.09 million cases), breast (2.09 million cases), colorectal (1.80 million cases), prostate (1.28 million cases), skin cancer (non-melanoma) (1.04 million cases), and stomach (1.03 million cases), whereas the most common causes of cancer-related death are malignancies of lung (1.76 million deaths), colorectum (862,000 deaths), stomach (783,000 deaths), liver (782,000 deaths), and breast (627,000 deaths) To this end, at least 30 to 50% of all cancer cases are preventable. The socio-economic burden can be illustrated by the example of prostate cancer as the disease for which the direct costs are increasing more quickly than those of any other cancer. The current article highlights very recent progress made in the area and provides prominent examples of a spectrum of liquid biopsy approaches with great potential to benefit several patient cohorts and to improve overall healthcare quality
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