Liquid Profiling for Cancer Patient Stratification in Precision Medicine—Current Status and Challenges for Successful Implementation in Standard Care

Diagnostics

Maren Hedtke¹  Verena Haselmann¹  Michael Neumaier¹ 

[1] Institute of Clinical Chemistry, University Medicine Mannheim, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany;

关键词: liquid biopsy;    circulating tumor DNA;    cell-free DNA;    cancer management;    personalized medicine;    standard care;   

DOI  :  10.3390/diagnostics12030748

来源: DOAJ

【 摘 要 】

Circulating tumor DNA (ctDNA), accurately described by the term liquid profiling (LP), enables real-time assessment of the tumor mutational profile as a minimally invasive test and has therefore rapidly gained traction, particular for the management of cancer patients. By LP, tumor-specific genetic alterations can be determined as part of companion diagnostics to guide selection of appropriate targeted therapeutics. Because LP facilitates longitudinal monitoring of cancer patients, it can be used to detect acquired resistant mechanisms or as a personalized biomarker for earlier detection of disease recurrence, among other applications. However, LP is not yet integrated into routine care to the extent that might be expected. This is due to the lack of harmonization and standardization of preanalytical and analytical workflows, the lack of proper quality controls, limited evidence of its clinical utility, heterogeneous study results, the uncertainty of clinicians regarding the value and appropriate indications for LP and its interpretation, and finally, the lack of reimbursement for most LP tests. In this review, the value proposition of LP for cancer patient management and treatment optimization, the current status of implementation in standard care, and the main challenges that need to be overcome are discussed in detail.

【 授权许可】

Unknown