Liquid biopsy in head and neck squamous cell carcinoma: circulating tumor cells, circulating tumor DNA, and exosomes

ABSTRACT

Introduction: Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers worldwide. Due to a lack of reliable markers, HNSCC patients are usually diagnosed at a late stage, which will lead to a worse outcome. Therefore, it is critical to improve the clinical management of cancer patients. Nowadays, the development of liquid biopsy enables a minimally invasive manner to extract molecular information from HNSCCs. Thus, this review aims to outline the clinical value of liquid biopsy in early detection, real-time monitoring, and prognostic evaluation of HNSCC.

Areas covered: This comprehensive review focused on the characteristics as well as clinical applications of three liquid biopsy markers (CTCs, ctDNA, and exosomes) in HNSCC. What is more, it is promising to incorporate machine learning and 3D organoid models in the liquid biopsy of HNSCC.

Expert opinion: Liquid biopsy provides a noninvasive technique to reflect the inter and intra-lesional heterogeneity through the detection of tumor cells or materials released from the primary and secondary tumors. Recently, some evolving technologies have the potential to combine with liquid biopsy to improve clinical management of HNSCC patients.

KEYWORDS:

• Head and neck squamous cell carcinoma
• circulating tumor cells
• circulating tumor DNA
• exosomes
• clinical application
• liquid biopsy

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Article highlights

• The confirmed circulating biomarkers (CTCs, ctDNA, and exosomes) in HNSCC have different characteristics.

• The three circulating biomarkers have the potential to apply in early detection, real-time monitoring, and prognostic evaluation of HNSCC.

• Machine learning and 3D organoid model are emerging technologies, which can be extended to the clinical applications of liquid biopsy in HNSCC.

Acknowledgments

This project was supported by the National Natural Science Foundation of China (Nos.81700522), the Natural Science Foundation of Anhui Province (1808085MH235, 1908085QH328); the University Natural Science Research Project of Anhui Province (KJ2018A0203); the Grants for Scientific Research of BSKY (XJ201706) from Anhui Medical University; the Key Research and development project of Anhui Province (1704f0804023).

Declaration of interest

The authors have no 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.

Additional information

Funding

This project was supported by the National Natural Science Foundation of China (Nos. 81700522); the Natural Science Foundation of Anhui Province (1808085MH235, 1908085QH328); the University Natural Science Research Project of Anhui Province (KJ2018A0203); the Grants for Scientific Research of BSKY (XJ201706) from Anhui Medical University; the Key Research and development project of Anhui Province (1704f0804023).