Testing for oncogenic molecular aberrations in cell-free DNA-based liquid biopsies in the clinic: are we there yet?
Abstract
The optimal choice of cancer therapy depends upon analysis of the rumor genome for druggable molecular alterations. The spatial and temporal intratumor heterogeneity of cencers creates substanital challenges, as molecular profile depends on time and site of tumor tissue collection.
To capture the entire molecular profile, multiple biopsies from primary and metastatic sites st different time points would be required, which is not feasible for ethical or economic reasons. Molecular analysis of circulating cell-free DNA offers a novel, minimally invasive method that can be performaed at multiple time-points and plausibly better represents the prevailing molucular profile of the cancer.
Molecular analysis of this cell-free DNA offers multiple clinically useful applications, such as identification of molecular targets for cancer therapy, monitoring of tumor molecular progile in real time, detection of emerging molecular aberrations associated with resistence to particular therapy, determination of cancer prognosis and diagnosis of cancer recurrence or progression.