Abstract
Nowadays, analyzing circulating tumor DNA (ctDNA), a very small part of circulating free DNA (cfDNA) carried by blood, is considered to be an interesting alternative to conventional single-site tumor tissue biopsies, both to assess tumor burden and provide a more comprehensive snapshot of the time-related and spatial heterogeneity of cancer genetic/epigenetic scenery. The determination of ctDNA and/or mapping its characteristic features, including tumor-specific mutations, chromosomal aberrations, microsatellite alterations, and epigenetic changes, are minimally invasive, powerful and credible biomarkers for early diagnosis, follow-up, prediction of therapy response/resistance, relapse monitoring, and tracking the rise of new mutant subclones, leading to improved cancer outcomes This review provides an outline of advances published in the last five years in electrochemical biosensing of ctDNA and surrogate markers. It emphasizes those strategies that have been successfully applied to real clinical samples. It highlights the unique opportunities they offer to shift the focus of cancer patient management methods from actual decision making, based on clinic-pathological features, to biomarker-driven treatment strategies, based on genotypes and customized targeted therapies. Also highlighted are the unmet hurdles and future key points to guide these devices in the development of liquid biopsy cornerstone tools in routine clinical practice for the diagnosis, prognosis, and therapy response monitoring in cancer patients.
Highlights
Cancer is one of the leading causes of death worldwide
During the last few years, the assessment methods for cancer patients are shifting from actual decision-making, based on patients’ clinic-pathological features to the biomarker-driven treatment strategies, relying on genotypes and customized targeted therapies
Being aware that intra-tumoral heterogeneity leads to temporal clonal evolution induced by therapy, which can lead to the development of acquired resistance to therapies that used to work effectively, active checking of tumors clonal genetic composition has been progressively recognized as a cornerstone procedure for improving patient results and their life quality
Summary
Cancer is one of the leading causes of death worldwide. According to the World Health. Electrochemical biosensors show remarkable features for the detection of ctDNA compared to these mentioned techniques, because of their great sensitivity, specificity, portability, plain use, rapid readout, and amenability to high levels of multiplexing and direct analysis in complex biological matrices. They are simple to fabricate, straightforward to automate and implement using cost-effective instrumentation, which make them applicable in point-of-care (POC) systems and/or undeveloped areas [1,10,11]. Adapted from [12] with permission a) and drawn based on [13] b)
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