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Liquid biopsy is a diagnostic repeatable test, which in last years has emerged as a powerful tool for profiling cancer genomes in real-time with minimal invasiveness and tailoring oncological decision-making. It analyzes different blood-circulating biomarkers and circulating tumor DNA (ctDNA) is the preferred one. Nevertheless, tissue biopsy remains the gold standard for molecular evaluation of solid tumors whereas liquid biopsy is a complementary tool in many different clinical settings, such as treatment selection, monitoring treatment response, cancer clonal evolution, prognostic evaluation, as well as the detection of early disease and minimal residual disease (MRD). A wide number of technologies have been developed with the aim of increasing their sensitivity and specificity with acceptable costs. Moreover, several preclinical and clinical studies have been conducted to better understand liquid biopsy clinical utility. Anyway, several issues are still a limitation of its use such as false positive and negative results, results interpretation, and standardization of the panel tests. Although there has been rapid development of the research in these fields and recent advances in the clinical setting, many clinical trials and studies are still needed to make liquid biopsy an instrument of clinical routine. This review provides an overview of the current and future clinical applications and opening questions of liquid biopsy in different oncological settings, with particular attention to ctDNA liquid biopsy.
Liquid biopsy is a diagnostic repeatable test, which in last years has emerged as a powerful tool for profiling cancer genomes in real-time with minimal invasiveness and tailoring oncological decision-making. It analyzes different blood-circulating biomarkers and circulating tumor DNA (ctDNA) is the preferred one. Nevertheless, tissue biopsy remains the gold standard for molecular evaluation of solid tumors whereas liquid biopsy is a complementary tool in many different clinical settings, such as treatment selection, monitoring treatment response, cancer clonal evolution, prognostic evaluation, as well as the detection of early disease and minimal residual disease (MRD). A wide number of technologies have been developed with the aim of increasing their sensitivity and specificity with acceptable costs. Moreover, several preclinical and clinical studies have been conducted to better understand liquid biopsy clinical utility. Anyway, several issues are still a limitation of its use such as false positive and negative results, results interpretation, and standardization of the panel tests. Although there has been rapid development of the research in these fields and recent advances in the clinical setting, many clinical trials and studies are still needed to make liquid biopsy an instrument of clinical routine. This review provides an overview of the current and future clinical applications and opening questions of liquid biopsy in different oncological settings, with particular attention to ctDNA liquid biopsy.
Introdução: O câncer colorretal (CCR) é resultado de divisões celulares descontroladas e desordenadas na região do cólon até o ânus, provocando alterações teciduais, sendo mundialmente o terceiro tipo de câncer mais comum. Além disso, antes não era possível tratar essa patologia devido às limitações da época, contudo, o avanço tecnológico permitiu novos mecanismos de intervenção para essa condição. Nesse sentido, o tratamento inicialmente consistia em quimioterapia e radioterapia, mas hoje existem meios mais eficazes e com menor prejuízo aos pacientes, como o uso de anticorpos monoclonais (MABS), nanomaterias e radioterapia de intensidade modulada (IMRT). Objetivos: Realizar uma revisão bibliográfica a respeito dos avanços tecnológicos no tratamento de Câncer colorretal. Metodologia: Esse estudo é uma revisão de bibliográfica acerca dos avanços tecnológicos no tratamento de CCR. Bases de dados: PubMed, Scielo ou Medline, Revista Cientifica Brasileira de Coloproctologia e guias de medicina ambulatorial e hospitalar de oncologia e artigos de clínica prática. Resultado e discussão: É possível perceber que há uma maior incidência de câncer colorretal em mulheres e em pessoas com maus hábitos de vida. O avanço tecnológico permitiu a realização de um diagnóstico mais eficaz e precoce, além de permitir o surgimento de tratamentos mais efetivos, menos invasivos e com melhor prognóstico para o paciente. Conclusão: A partir de estudos recentes é possível a utilização de novos medicamentos com menores taxas de acometimento de células saudáveis, por meio de métodos cada vez menos invasivos e com maiores taxas de sucesso.
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