Updates on liquid biopsy: current trends and future perspectives for clinical application in solid tumors

Abstract

Despite advances in screening and therapeutics cancer continues to be one of the major causes of morbidity and mortality worldwide. The molecular profile of tumor is routinely assessed by surgical or bioptic samples, however, genotyping of tissue has inherent limitations: it represents a single snapshot in time and it is subjected to spatial selection bias owing to tumor heterogeneity. Liquid biopsy has emerged as a novel, non-invasive opportunity of detecting and monitoring cancer in several body fluids instead of tumor tissue. Circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), RNA (mRNA and microRNA), microvesicles, including exosomes and tumor “educated platelets” were recently identified as a source of genomic information in cancer patients which could reflect all subclones present in primary and metastatic lesions allowing sequential monitoring of disease evolution. In this review, we summarize the currently available information concerning liquid biopsy in breast cancer, colon cancer, lung cancer and melanoma. These promising issues still need to be standardized and harmonized across laboratories, before fully adopting liquid biopsy approaches into clinical practice.

Current Technologies for RNA-Directed Liquid Diagnostics

“…Liquid biopsy of circulating biomarkers has the potential to be developed as a minimally invasive diagnostic methodology for precision medicine, and its potential values have received increasing attention over the last decades [131][132][133]. Several traditional blood tumour marker proteins, such as CA15-3, CA19-9 and PSA markers are already regularly used in the patient management of respectively breast, colorectal, and prostate cancer [134].…”

“…For instance, in 2017, the average cost for solid biopsy for lung cancer was $8869, while the total cost for a patient reached $37,745 because of 20% complications from needle biopsies [132,143]. Moreover, a transthoracic needle biopsy under computer tomography control may cost around $500, which is more than enough for a blood test as the current cost of single ct-DNA mutant detection with digital PCR is approximately $100 [99,133]. In addition, researchers from Johns Hopkins University have developed a multi-analysis blood assay that currently costs less than $500 [133,134].…”

“…Moreover, a transthoracic needle biopsy under computer tomography control may cost around $500, which is more than enough for a blood test as the current cost of single ct-DNA mutant detection with digital PCR is approximately $100 [99,133]. In addition, researchers from Johns Hopkins University have developed a multi-analysis blood assay that currently costs less than $500 [133,134].…”

CRISPR/Cas13-Based Platforms for a Potential Next-Generation Diagnosis of Colorectal Cancer through Exosomes Micro-RNA Detection: A Review

“…A blood-based miRNA diagnostic for cancers is currently trending and being in-tensely studied [ 127 , 136 , 153 , 154 ]. Therefore, the current challenges previously mentioned may soon be addressed and tackled.…”

Defining the landscape of circRNAs in non-small cell lung cancer and their potential as liquid biopsy biomarkers: a complete review including current methods

“…Lung cancer involves massive changes in RNA metabolism, both in the tumor and circulating EVs and TEPs. Traditional RNA biomarker discovery research for either lung cancer detection or monitoring of treatment response has mainly focused on the expression of mRNA and miRNA [5][6][7] .…”