Precision medicine for cancer patients aims to adopt the most suitable treatment options during diagnosis and treatment of individuals. Detecting circulating tumor cell (CTC) or circulating tumor DNA (ctDNA) in plasma or serum could serve as liquid biopsy, which would be useful for numerous diagnostic applications. Liquid biopsies can help clinicians screen and detect cancer early, stratify patients to the most suitable treatment and real-time monitoring of treatment response and resistance mechanisms in the tumor, evaluate the risk for metastatic relapse, and estimate prognosis.
Researchers from the Beijing Institute of Genomics summarize the advantages and disadvantages of tissue and liquid biopsies.They also further compare and analyze the advantages and limitations of detecting CTCs, ctDNAs, and exosomes. Furthermore, the researchers review the literature related with the application of serum or plasma CTCs, ctDNAs, and exosomes for diagnosis and prognosis of cancer. They also analyze their opportunities and challenges as future biomarkers. In the future, liquid biopsies could be used to guide cancer treatment. They could also provide the ideal scheme to personalize treatment in precision medicine.
Clinical applications of liquid biopsy for precision medicine
CTCs, ctDNAs, and exosomes as liquid biopsy for precision medicine, including screening and early detection of cancer, real-time monitoring of therapy, stratification and therapeutic intervention, therapeutic target and resistance mechanism, risk for metastatic relapse (prognosis), and improvement of drug delivery with exosomes.