Abstract
Improving cancer survival rates globally requires improvements in disease detection and monitoring, with the aim of improving early diagnosis and prediction of disease relapse. Traditional means of detecting and monitoring cancers rely largely on imaging and, where possible, blood-based protein biomarkers, many of which are non-specific. Treatments are being improved by identification of inherited and acquired genomic aberrations in tumors, some of which can be targeted by newly developed therapeutic interventions. Treatment of gynecological malignancy is progressively moving toward personalized therapy, as exemplified by application of PARP-inhibition for patients with BRCA-deficient tubo-ovarian cancers, or checkpoint inhibition in patients with mismatch repair-deficient disease. However, the more recent discovery of a group of biomarkers described under the umbrella term of “liquid biopsy” promises significant improvement in our ability to detect and monitor cancers. The term “liquid biopsy” is used to describe an array of tumor-derived material found in blood plasma and other bodily fluids such as ascites, pleural fluid, saliva, and urine. It includes circulating tumors cells (CTCs), circulating nucleic acids including DNA, messenger RNA and micro RNAs, and extracellular vesicles (EVs). In this review, we discuss recent advancements in liquid biopsy for biomarker detection to help in diagnosis, prognosis, and planning of treatment of ovarian and endometrial cancer.
Highlights
Genomic Changes in Cancer CellsCancer is a ubiquitous disease, with 18 million new cases and 9.5 million cancer-related deaths reported annually worldwide [1]
We further discuss current developments in the field of precision oncology in endometrial cancer and ovarian cancer and how improving knowledge in “liquid biopsy” research are contributing to the development of both targeted anti-cancer therapy and disease monitoring
Summary
Cancer is a ubiquitous disease, with 18 million new cases and 9.5 million cancer-related deaths reported annually worldwide [1]. Despite increasing advances in technology and improvement in our understanding of tumor biology, a number of challenges exist These include the difficulty of obtaining tumor biopsies from which DNA of appropriate quality and quantity can be used for genomic analysis, the presence of intra-, and intertumoral genomic heterogeneity [8] which hinders both our understanding of tumors [9] and response to targeted agents [10], and dynamic change in tumors over time, after treatment resulting development of resistance [11]. No such preventative vaccine programme exists, as yet, for endometrial or ovarian cancer, much research has focused on development of vaccine for Lynch syndrome-related malignancies [17,18,19]. No screening test has been conclusively proven to impact mortality of ovarian/endometrial cancer in women at population-level or higher risk
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