Current status of ctDNA in precision oncology for hepatocellular carcinoma

Abstract

The conventional method used to obtain a tumor biopsy for hepatocellular carcinoma (HCC) is invasive and does not evaluate dynamic cancer progression or assess tumor heterogeneity. It is thus imperative to create a novel non-invasive diagnostic technique for improvement in cancer screening, diagnosis, treatment selection, response assessment, and predicting prognosis for HCC. Circulating tumor DNA (ctDNA) is a non-invasive liquid biopsy method that reveals cancer-specific genetic and epigenetic aberrations. Owing to the development of technology in next-generation sequencing and PCR-based assays, the detection and quantification of ctDNA have greatly improved. In this publication, we provide an overview of current technologies used to detect ctDNA, the ctDNA markers utilized, and recent advances regarding the multiple clinical applications in the field of precision medicine for HCC.

Non-Invasive Biomarkers for Immunotherapy in Patients with Hepatocellular Carcinoma: Current Knowledge and Future Perspectives

“…Similarly, ctDNA MAF has been reported to change dynamically after surgery and to correlate with recurrence-free survival and OS [ 92 ]. Despite these promising results, at present, the application of ctDNA as a biomarker is limited, mainly due to the lack of standardized procedures for sample preparation and the difficulty of determining the assay when the ctDNA levels are very low [ 93 ].…”

“…Compared with traditional AFP, it has been shown that ctDNA [ 81 , 82 , 83 ] might be a better prognostic marker of responses in patients with unresectable HCC, but these findings have not been confirmed in other studies. This could be due to the low levels of CTC and ctDNA that can be found in body fluids, which reduce their application in standard diagnostic and prognostic procedures, and to the lack of antibodies against membrane markers of these products [ 93 , 106 , 154 ]. High costs and the need for multiple platforms and technologies for the comprehensive analysis of tumor products should also be mentioned as limitations for the dissemination and application of noninvasive biomarkers [ 93 , 106 , 154 ].…”

“…This could be due to the low levels of CTC and ctDNA that can be found in body fluids, which reduce their application in standard diagnostic and prognostic procedures, and to the lack of antibodies against membrane markers of these products [ 93 , 106 , 154 ]. High costs and the need for multiple platforms and technologies for the comprehensive analysis of tumor products should also be mentioned as limitations for the dissemination and application of noninvasive biomarkers [ 93 , 106 , 154 ]. The main limitation of liquid biopsy is related to the lack of standardized protocols and the limited data available.…”

Role of Circulating Tumor DNA in Gastrointestinal Cancers: Current Knowledge and Perspectives

“…Finally, other approaches are currently emerging to overcome sequencing technologies biases, such as plasmonic nanoparticles used in Surface-Enhanced Raman Scattering (SERS), mass spectrometry based assays and electrochemical biosensor technologies [ 7 , 21 , 22 , 23 ].…”

Correction to: Current status of ctDNA in precision oncology for hepatocellular carcinoma

“…Following publication of the original article [ 1 ], the authors identified an error in the author affiliations. Chuanyong Guo’s first affiliation was missing; Chuanyong Guo’s affiliations are therefore: 1 Department of Gastroenterology, Putuo People’s Hospital, Tongji University School of Medicine, number 1291, Jiangning road, Putuo, Shanghai, 200060, China 2 Department of Gastroenterology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Number 301, Middle Yanchang road, Jing’an, Shanghai 200072, China …”