Monitoring Cancer through the blood
Abstract
Tumor biopsies remain the gold standard for evaluating genetic changes in cancers either at diagnosis or following treatment with targeted therapies. However, this is not always feasible and can seldom be performed more than once. Noninvasive techniques, so-called “liquid biopsies” that measure the allelic burden in blood promise to realize the full potential of genotype-directed cancer therapy. These technologies can be potentially used for non-invasive tumor genotyping and in addition also provide an opportunity for disease monitoring and as a tool for pharmacodynamic assessment of drug efficacy. These features offer the ability to gain real-time dynamic biological insights into the benefits and failures of cancer therapies.
Several publications have demonstrated the potential of plasma cell-free DNA (cfDNA) genotyping. While historical studies focused on measuring total cfDNA concentrations for diagnosis and prognosis of disease, recent technologic advances now enable the ability to obtain novel molecular insights non-invasively 1-4. First, monitoring response to treatment, i.e., does one observe a reduction (or increase) in a population of tumor derived mutant alleles from cfDNA that track with treatment response observed by radiographic imaging? Second, monitoring of known, actionable resistance clones that arise, as a result, of selective pressure from targeted therapy. The latter is particularly interesting as there are now several drugs in the clinic that…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 24 participants or records.
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