Circulating Cell-Free Tumour DNA in the Management  of Cancer

Francis, Glenn; Stein, Sandra

doi:10.3390/ijms160614122

Cited by 97 publications

(82 citation statements)

References 100 publications

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“…This could be achieved by liquid biopsy either addressing circulating tumour cells or cell-free DNA like ctDNA. These approaches are useful in the selection of the treatment, monitoring and evaluation of early recurrence and minimal residual disease, and resistance acquisition [123][124][125]. This methodology is also relevant when patients show no tolerance to a new biopsy, if there are several metastases in different localizations, when the tissue is insufficient or has artefacts related for instance to decalcification, when there are problems related to heterogeneity or when biopsy imposes risks [124].…”

Section: Doi: 101159/000487440mentioning

confidence: 99%

Heterogeneity in Lung Cancer

2018

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Lung cancer diagnosis is a challenge since it is also one of the most frequently diagnosed cancers. Diagnostic challenges are deeply related to the development of personalized therapy and molecular and precise histological characterizations of lung cancer. When addressing these features, it is very important to acknowledge the issue of tumour heterogeneity, as it imposes several questions. First of all, lung cancer is a very heterogeneous disease, at a cellular and histological level. Cellular and histological heterogeneity are addressed with emphasis on the diagnosis, pre-neoplastic lesions, and cell origin, trying to contribute to a better knowledge of carcinogenesis. Molecular intra-tumour and inter-tumour heterogeneity are also addressed as temporal heterogeneity. Lung cancer heterogeneity has implications in pathogenesis understanding, diagnosis, selection of tissue for molecular diagnosis, as well as therapeutic decision. The understanding of tumour heterogeneity is crucial and we must be aware of the implications and future developments regarding this field.

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Section: Doi: 101159/000487440mentioning

confidence: 99%

Heterogeneity in Lung Cancer

2018

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“…Circulating tumor DNA (ctDNA) is composed of small fragments (about 150-200 base pairs) of DNA that are released from cells undergoing apoptosis or necrosis in malignant lesions (primary or metastatic) and can be detected and sequenced in the blood of patients with cancer (6,7). Detection of cell-free DNA was first described in 1987 by Stroun and collegues (8), and numerous articles were published in the past few years, indicative of a growing interest in this noninvasive diagnostic method (9)(10)(11)(12)(13)(14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Use of Liquid Biopsies in Clinical Oncology: Pilot Experience in 168 Patients

Schwaederlé¹,

Husain²,

Fanta³

et al. 2016

Clinical Cancer Research

123

124

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Purpose: There is a growing interest in using circulating tumor DNA (ctDNA) testing in patients with cancer. Experimental Design: A total of 168 patients with diverse cancers were analyzed. Patients had digital next-generation sequencing (54 cancer-related gene panel including amplifications in ERBB2, EGFR, and MET) performed on their plasma. Type of genomic alterations, potential actionability, concordance with tissue testing, and patient outcome were examined. Results: Fifty-eight percent of patients (98/168) had ≥1 ctDNA alteration(s). Of the 98 patients with alterations, 71.4% had ≥ 1 alteration potentially actionable by an FDA-approved drug. The median time interval between the tissue biopsy and the blood draw was 2.7 months for patients with ≥ 1 alteration in common compared with 14.4 months (P = 0.006) for the patients in whom no common alterations were identified in the tissue and plasma. Overall concordance rates for tissue and ctDNA were 70.3% for TP53 and EGFR, 88.1% for PIK3CA, and 93.1% for ERBB2 alterations. There was a significant correlation between the cases with ≥ 1 alteration with ctDNA ≥ 5% and shorter survival (median = 4.03 months vs. not reached at median follow-up of 6.1 months; P < 0.001). Finally, 5 of the 12 evaluable patients (42%) matched to a treatment targeting an alteration(s) detected in their ctDNA test achieved stable disease ≥ 6 months/partial remission compared with 2 of 28 patients (7.1%) for the unmatched patients, P = 0.02. Conclusions: Our initial study demonstrates that ctDNA tests provide information complementary to that in tissue biopsies and may be useful in determining prognosis and treatment. Clin Cancer Res; 22(22); 5497–505. ©2016 AACR.

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“…6 Positron emission tomography-computed tomography imaging, in contrast, generally detects tumors measuring no less than 7 to 10 mm in size and containing~1 billion cells. 7 Although efforts to capture CTCs or genetic material in patient blood have been ongoing for several years, recent advances in cell capture devices, plasma isolation techniques, and highly sensitive polymerase chain reaction (PCR)-and sequencing-based methods have made it financially and technically feasible to introduce the liquid biopsy of solid tumors into the clinic.…”

Section: Liquid Biopsy Techniquesmentioning

confidence: 99%

Liquid Biopsy in Lung Cancer: A Perspective From Members of the Pulmonary Pathology Society

Sholl¹,

Aisner²,

Allen³

et al. 2016

Archives of Pathology &Amp; Laboratory Medicine

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Liquid biopsy has received extensive media coverage and has been called the holy grail of cancer detection. Attempts at circulating tumor cell and genetic material capture have been progressing for several years, and recent financially and technically feasible improvements of cell capture devices, plasma isolation techniques, and highly sensitive polymerase chain reaction– and sequencing-based methods have advanced the possibility of liquid biopsy of solid tumors. Although practical use of circulating RNA-based testing has been hindered by the need to fractionate blood to enrich for RNAs, the detection of circulating tumor cells has profited from advances in cell capture technology. In fact, the US Food and Drug Administration has approved one circulating tumor cell selection platform, the CellSearch System. Although the use of liquid biopsy in a patient population with a genomically defined solid tumor may potentially be clinically useful, it currently does not supersede conventional pretreatment tissue diagnosis of lung cancer. Liquid biopsy has not been validated for lung cancer diagnosis, and its lower sensitivity could lead to significant diagnostic delay if liquid biopsy were to be used in lieu of tissue biopsy. Ultimately, notwithstanding the enthusiasm encompassing liquid biopsy, its clinical utility remains unproven.

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Circulating Cell-Free Tumour DNA in the Management of Cancer

Cited by 97 publications

References 100 publications

Heterogeneity in Lung Cancer

Heterogeneity in Lung Cancer

Use of Liquid Biopsies in Clinical Oncology: Pilot Experience in 168 Patients

Liquid Biopsy in Lung Cancer: A Perspective From Members of the Pulmonary Pathology Society

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