Liquid biopsy challenge and hope in colorectal cancer

ABSTRACT

Introduction: Colorectal cancer is an important global health burden marked by a high mortality rate. Medical attention is drawn more often by the new targeted therapies, but also by the concept of liquid biopsy. Tumor’s genetic profile is the major indicator of the response to targeted therapies and the risk for metastatic relapse. Therefore, analysis of tumor-linked genetic alterations holds a great importance, both for diagnostic and prognostic purposes.

Areas covered: The present paper highlights the molecular basis of the liquid biopsy concept and its major clinical applications in colorectal cancer. This consists in circulating tumor cells (CTC) and cell-free tumor DNA (cfDNA) and is described in manuscripts as an alternative to tissue samples, providing more information about tumor heterogeneity and tumor evolution in dynamic.

Expert opinion: Liquid biopsy is an innovative, minimally invasive method which enables real-time monitoring of tumor’s genetic heterogeneity, being an important step towards personalized medicine. However, despite the large number of detection methods available, it is necessary to standardize them regarding the blood collection processing and sample storage, analysis in order to be implemented in clinical guidelines.

KEYWORDS:

• Colorectal cancer
• circulating tumor cell
• cell-free tumor DNA
• liquid biopsy

Article highlights

• Liquid biopsy analysis represents a subject of major interest for the treatment of patients with cancer.

• Evaluation of CTC or cfDNA offers information about early tumor release, development of tumor metastasis and also about mechanisms involved in tumor resistance to treatment.

• There are some limits of different methods used for liquid biopsy analysis responsible for false-positive results.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This work was supported by ‘Iuliu Hatieganu’ University of Medicine and Pharmacy Cluj-Napoca, Romania under Grant No. 4945/7/08.03.2016.