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Curated Papers > High-impact authoritative literature on "liquid biopsy"

Clinical Applications of Circulating Tumor Cells and Circulating Tumor DNA as Liquid Biopsy. ​

Literature Information ​

DOI10.1158/2159-8290.CD-15-1483
PMID26969689
JournalCancer discovery
Impact Factor33.3
JCR QuartileQ1
Publication Year2016
Times Cited673
KeywordsCirculating Tumor Cells, Circulating Tumor DNA, Liquid Biopsy, Personalized Medicine, Cancer Detection
Literature TypeJournal Article, Research Support, Non-U.S. Gov't, Review
ISSN2159-8274
Pages479-91
Issue6(5)
AuthorsCatherine Alix-Panabières, Klaus Pantel

TL;DR ​

This review highlights the clinical potential of liquid biopsy through the analysis of circulating tumor cells (CTCs) and circulating cell-free tumor DNA (ctDNA) for cancer detection, prognosis prediction, and therapy monitoring. While these methods show promise for personalized medicine, challenges in assay specificity and sensitivity must be addressed, necessitating further interventional studies for effective implementation.

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Circulating Tumor Cells · Circulating Tumor DNA · Liquid Biopsy · Personalized Medicine · Cancer Detection

Abstract ​

UNLABELLED "Liquid biopsy" focusing on the analysis of circulating tumor cells (CTC) and circulating cell-free tumor DNA (ctDNA) in the blood of patients with cancer has received enormous attention because of its obvious clinical implications for personalized medicine. Analyses of CTCs and ctDNA have paved new diagnostic avenues and are, to date, the cornerstones of liquid biopsy diagnostics. The present review focuses on key areas of clinical applications of CTCs and ctDNA, including detection of cancer, prediction of prognosis in patients with curable disease, monitoring systemic therapies, and stratification of patients based on the detection of therapeutic targets or resistance mechanisms.

SIGNIFICANCE The application of CTCs and ctDNA for the early detection of cancer is of high public interest, but it faces serious challenges regarding specificity and sensitivity of the current assays. Prediction of prognosis in patients with curable disease can already be achieved in several tumor entities, particularly in breast cancer. Monitoring the success or failure of systemic therapies (i.e., chemotherapy, hormonal therapy, or other targeted therapies) by sequential measurements of CTCs or ctDNA is also feasible. Interventional studies on treatment stratification based on the analysis of CTCs and ctDNA are needed to implement liquid biopsy into personalized medicine. Cancer Discov; 6(5); 479-91. ©2016 AACR.

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Primary Questions Addressed ​

  1. What are the current limitations in the specificity and sensitivity of assays for detecting circulating tumor cells and ctDNA?
  2. How do the clinical applications of CTCs and ctDNA differ across various types of cancers beyond breast cancer?
  3. What advancements in technology could enhance the accuracy of liquid biopsy methods in the near future?
  4. In what ways can the analysis of CTCs and ctDNA contribute to the development of new therapeutic targets or resistance mechanisms?
  5. What are the ethical considerations surrounding the use of liquid biopsies in personalized medicine, particularly in terms of patient consent and data privacy?

Key Findings ​

1. Research Background and Purpose ​

The study explores the concept of "liquid biopsy," which involves the analysis of circulating tumor cells (CTCs) and circulating cell-free tumor DNA (ctDNA) found in the blood of cancer patients. The primary aim is to highlight the clinical implications of these biomarkers for personalized medicine, emphasizing their potential in revolutionizing cancer diagnostics and treatment. Liquid biopsy represents a minimally invasive approach that could significantly improve early cancer detection, prognosis evaluation, therapy monitoring, and patient stratification.

2. Main Methods and Findings ​

The review synthesizes existing literature on the clinical applications of CTCs and ctDNA. It discusses various methodologies employed for their detection, including advanced genomic and molecular techniques that allow for sensitive and specific identification of these biomarkers. Key findings indicate that while CTCs and ctDNA provide promising avenues for early cancer detection, there are significant challenges in terms of assay specificity and sensitivity that need to be addressed. The review also highlights successful prognostic predictions in certain cancers, particularly breast cancer, where CTCs and ctDNA can help assess outcomes in patients with curable diseases. Additionally, it points out the feasibility of using these markers to monitor the efficacy of systemic therapies, such as chemotherapy and targeted therapies, through serial assessments.

3. Core Conclusions ​

The review concludes that CTCs and ctDNA are essential components of liquid biopsy diagnostics, offering valuable insights into cancer detection, prognosis, and treatment response. Despite the challenges related to assay performance, existing evidence supports their utility in clinical practice, particularly in monitoring treatment and predicting patient outcomes. However, the authors stress the need for further interventional studies to validate these findings and enhance the integration of liquid biopsy into personalized medicine frameworks.

4. Research Significance and Impact ​

This review underscores the transformative potential of liquid biopsy in oncology by providing a non-invasive method for cancer diagnosis and management. The ability to detect CTCs and ctDNA can lead to timely interventions, tailored therapies, and improved patient outcomes. The insights gained from this research could pave the way for broader clinical implementation of liquid biopsy in routine practice, ultimately enhancing the personalization of cancer treatment. The findings also highlight the critical need for ongoing research to refine methodologies, improve assay accuracy, and facilitate the adoption of liquid biopsy as a standard component of cancer care, with implications for patient-centered approaches in oncology.

Literatures Citing This Work ​

  1. Vesicle-MaNiA: extracellular vesicles in liquid biopsy and cancer. - Veronica Torrano;Felix Royo;Héctor Peinado;Ana Loizaga-Iriarte;Miguel Unda;Juan M Falcón-Perez;Arkaitz Carracedo - Current opinion in pharmacology (2016)
  2. TP53 mutations on circulating cell-free DNA. - Klaus Pantel - EBioMedicine (2016)
  3. Short term ex-vivo expansion of circulating head and neck tumour cells. - Arutha Kulasinghe;Chris Perry;Majid E Warkiani;Tony Blick;Anthony Davies;Ken O'Byrne;Erik W Thompson;Colleen C Nelson;Ian Vela;Chamindie Punyadeera - Oncotarget (2016)
  4. Circulating Tumor Cells in the Adenocarcinoma of the Esophagus. - Giulia Gallerani;Francesco Fabbri - International journal of molecular sciences (2016)
  5. Pathologists and liquid biopsies: to be or not to be? - Paul Hofman;Helmut H Popper - Virchows Archiv : an international journal of pathology (2016)
  6. Cell-free DNA and next-generation sequencing in the service of personalized medicine for lung cancer. - Catherine W Bennett;Guy Berchem;Yeoun Jin Kim;Victoria El-Khoury - Oncotarget (2016)
  7. Circulating Tumor Cells (CTC) and Cell-Free DNA (cfDNA) Workshop 2016: Scientific Opportunities and Logistics for Cancer Clinical Trial Incorporation. - Lori E Lowes;Scott V Bratman;Ryan Dittamore;Susan Done;Shana O Kelley;Sabine Mai;Ryan D Morin;Alexander W Wyatt;Alison L Allan - International journal of molecular sciences (2016)
  8. The Challenges of Detecting Circulating Tumor Cells in Sarcoma. - Marta Tellez-Gabriel;Hannah K Brown;Robin Young;Marie-Françoise Heymann;Dominique Heymann - Frontiers in oncology (2016)
  9. The Cohesive Metastasis Phenotype in Human Prostate Cancer. - William L Harryman;James P Hinton;Cynthia P Rubenstein;Parminder Singh;Raymond B Nagle;Sarah J Parker;Beatrice S Knudsen;Anne E Cress - Biochimica et biophysica acta (2016)
  10. Heterogeneity of Cancer Stem Cells: Rationale for Targeting the Stem Cell Niche. - Maximilian Boesch;Sieghart Sopper;Alain G Zeimet;Daniel Reimer;Guenther Gastl;Burkhard Ludewig;Dominik Wolf - Biochimica et biophysica acta (2016)

... (663 more literatures)

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