Liquid Biopsy Challenges

The new technology of liquid biopsy (liquid biopsy) allows the accurate observation of a tumor and timely response to resistance development of the cells.

Advantages and limitations of the procedure

The advantage of the Liquid Biopsy is obvious – instead of an invasive sample taking a blood sample is sufficient. The method is therefore also suitable for cancers in which a needle biopsy is risky, in lung or brain tumors.

The main challenge is the use of Liquid Biopsy is subject to change. Because there are still too many uncertainties in the procedure in order to be able to make reliable statements for diagnostics or therapy. Cell-free circulating tumor DNA is not detected in all, but in about 70 percent of metastatic tumors. According to the authors of the statement, “The opportunities and risks of blood-based molecular-pathological analysis of circulating tumor cells (CTC) and cell-free DNA (cfDNA) in personalized cancer therapy” can be determined, depending on the tumor stage. For cerebral tumors cfDNA detection is even completely unsuitable because of the blood-brain barrier,

Critically, some molecular pathologists also consider the commercial blood-based analysis of tumor-specific driver mutations. There is still a lack of standardization of existing cfDNA isolation and analysis technologies as well as quality management of sample processing.

Value of the Liquid Biopsy

There are a few procedures in the field of “liquid biopsies” that are already important in clinical practice. They are used in the follow-up and characterization of cancer. Some tumour markers are determined for follow-up and aftercare: These include, for example, PSA in prostate cancer or CEA in colorectal cancer. Another example of the use of tumour markers is the detection of circulating tumour cells using the CellSearch® system as a prognosis factor in breast cancer.

New additions are the first Liquid Biopsy-based tests for gene alterations, which under certain circumstances are used instead of a conventional biopsy for lung cancer. Many other applications are being investigated in studies, but are still in the experimental stage. Liquid Biopsy-based tests for the early detection of cancer are already being offered commercially in some cases. As a rule, too little data is still available on these tests from studies in order to assess their potential benefit and harm in the treatment of cancer.

It therefore remains to be seen whether these tests are accurate enough to prove themselves as – possibly even population-wide early detection measures.

Is a Liquid Biopsy useful?
Before a Liquid Biopsy is performed, it should be clarified to be: What are the possible consequences can be drawn from the result? If and how must with adapted the therapy to a certain test result to be? Is the benefit of the test through high-quality investigations occupied?

For cancers such as lung, brain and pancreas, which have always been difficult to diagnose in the initial stage, liquid biopsy could be a life saving technique. For this hope to be realized, further research will be required to improve technology until it is fast, cost-effective, accurate and sensitive. For more information on liquid biopsy visit the following link.

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