Abstract
Liquid biopsy is a technique that utilizes circulating biomarkers in the body fluids of cancer patients to provide information regarding the genetic landscape of the cancer. It is emerging as an alternative and complementary diagnostic and prognostic tool to surgical biopsy in oncology. Liquid biopsy focuses on the detection and isolation of circulating tumor cells, circulating tumor DNA and exosomes, as a source of genomic and proteomic information in cancer patients. Liquid biopsy is expected to provide the necessary acceleratory force for the implementation of precision oncology in clinical settings by contributing an enhanced understanding of tumor heterogeneity and permitting the dynamic monitoring of treatment responses and genomic variations. However, widespread implementation of liquid biopsy based biomarker-driven therapy in the clinical practice is still in its infancy. Technological advancements have resolved many of the hurdles faced in the liquid biopsy methodologies but sufficient clinical and technical validation for specificity and sensitivity has not yet been attained for routine clinical implementation. This article provides a comprehensive review of the clinical utility of liquid biopsy and its effectiveness as an important diagnostic and prognostic tool in colorectal, breast, hepatocellular, gastric and lung carcinomas which were the five leading cancer related mortalities in 2018.
Highlights
Decades of astounding cancer research has defined cancer to be a disease that involves mutations in the cell genome [1]
The present study focuses on the clinical utility of liquid biopsy in the top five cancers that were the leading causes of cancer-related mortality in 2018 as per the GLOBOCAN 2018
Liquid biopsy, obtained with a routine blood draw, overcomes most of the limitations of tissues and can provide rapid detection of the tumor genetics including de novo and resistant mutations [13]. This technique involves the analysis of circulating tumor DNA, cell-free DNA, exosomes, RNA and circulating tumor cells (CTCs) in the body fluids to determine the mutational status [14]
Summary
Decades of astounding cancer research has defined cancer to be a disease that involves mutations in the cell genome [1]. One of the prime challenges for the clinical implementation of precision oncology is to identify and detect molecular biomarkers that could predict the prognosis, sensitivity or resistance to a specific single agent or combination therapies, or specific therapy-associated adverse drug reactions [6] In this scenario, liquid biopsy has been recently gaining widespread attention globally as an alternative/complementary to tissue biopsy in the era of “cancer theranostics” by being a minimally invasive prognostic and diagnostic tool that can assess the genetic landscape of various solid tumors. Liquid biopsy, obtained with a routine blood draw, overcomes most of the limitations of tissues and can provide rapid detection of the tumor genetics including de novo and resistant mutations [13] This technique involves the analysis of circulating tumor DNA, cell-free DNA, exosomes, RNA (mRNA and microRNA) and circulating tumor cells (CTCs) in the body fluids to determine the mutational status [14]. Aid precision oncology [22]
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