Nature sub-publication in-depth interpretation! Progress in the application of ctDNA-based liquid biopsy technology in cancer diagnosis!

, June 29, 2020 /PRNewswire-BIOON-- A recent review report published in the international journalNature Cancerentitled "Circulating Tumor DNA and Liquid Biopsy iny", scientists from the University of Toronto analyzed the progress of research on circulating tumor DNA and tumor liquid biopsy; CirculatingtumorsDNA to detect and monitor cancer technology is becoming more sophisticated, and a growing body of research evidence reveals the technology's ability in diagnostic tests, and the full potential of ctDNA liquid biopsy indiagnostic, characteristic analysis and management of solid tumors and malignant blood cancers will be revealed by evaluating clinically practical interventionalclinical trial sands, this review report summarizesThe researchers discussed the application of ctDNA liquid biopsy in cancer detection and the future clinical application, the researchers explained from the following aspects: 1) ctDNA in metastatic solid tumors; 2) genomic relevance of immunotherapy responses, 3) from clinical trials to clinical applications, 4) the dynamic sedDNA dynamics and therapeutic responses, 5) identification and characterization of acquired drug resistance, 6) diagnosisand screening of precancerous, 7) introduction of ctDNA-based cancer screening, 8) the design of
clinical trials based on ct-based, etcresearchers say that establishing ctDNA-based cancer screening may require the integration of such testing techniques into existing clinical care treatments, and that people at higher cancer risk are often screened for primary cancer because of the relative reduction in the associated harm; Procedures, including regular physical examinations, blood tests, and medical imaging, are similar, and the researchers also recommend that people screen for cervical cancer within a defined age range to increase the positive prediction of screening tests, which may be ideal for evaluating ctDNA-based screening strategies, since existing trials have fundamental characteristics that can form comparisons Picture Source: Wikimedia
It may be further to see whether ctDNA will one day replace existing screening tests, or supplement existing screening tests by addressing uncertain results, and it may be further observed that low-dose computer tomography (CT) has now become an effective high sensitivity test for early-stage lung cancer, but its positive predictions may still be low In this case, CTDNA testing after CT scan can improve the accuracy of overall screening, but also to reduce unnecessary intrusive and expensive follow-up procedures, in addition, if the ctDNA detection technology is improved, it may completely replace low-dose CT scan for lung cancer screening, but also can reduce the burden of secondary cancer caused by CT ionizing radiation, EBV qPCR testing can provide the main basis for high-sensitivity primary cancer screening based on CTDNA, and secondary research needs to be identified In the landmark nasopharyngeal cancer screening study, when EBV ctDNA positive results are shown, researchers use nasal endoscopy to examine and confirm diagnosis for nasopharyngeal cancer, so that, in addition to the properties of ctDNA analysis (sensitivity, specificity, and cost), the characteristics of existing complementary tests will provide more valuable information for the best screening methods for specific cancer types Finally, extensive implementation has also been followed by a broader cost-benefit assessment that will take into account the overall impact of ctDNA-based screening on clinical management and population health, and researchers can provide a number of cases to demonstrate the value of ctDNA to increase existing screening methods ctDNA-based clinical trials
focusing on clinical applications in the early stages of cancer and precancerous, are expected to flourish in the coming years, and many reports and ongoing liquid biopsy studies observation seditious or cross-sectional studies, the main purpose of which is to assess the performance and characteristics of ctDNA in detecting cancer incidence, recurrence, or relatively conventional therapy (such as imaging tools or serum tumor markers) The researchers have proposed several innovative ctDNA-driven clinical trials design frameworkthat that highlights the opportunities for therapeutic interventions based on complete liquid biomarker biomarkers , some of which can evaluate ctDNA detection strategies and randomly assign patients to standard monitoring or non-ctDNA guidance, while others test and triage all subjects for ctDNA testing and triage based on test results Platform solutions such as umbrella trial design or basket trial design have also been timely promoted, especially in the case of recurrent or metastatic diseases, in which researchers met with genotype drugs to match immunotherapy to determine the removal effect of ctDNA and the long-term clinical benefits of its transformation With the establishment of laboratory platforms and the good results obtained by the Observational Institute, ctDNA-based liquid biopsy diagnostic technology is entering the third wave of clinical tumor , and the researchers predict that the rapid use of ctDNA intact biomarkers in interventional therapeutic trials may identify multiple clinical markers Applications, and they can then be incorporated into routine clinical care, so careful consideration of the basic principles of biomarkers design in analytical development, interpretation, and clinical evaluation, and attention to disease-related variables that increase the complexity of ctDNA assessment may be critical to maximizing the impact of this technology in cancer treatment (BioValley Bioon.com) References: Cescon, D.W., Bratman, S., Chan, S.M et al Circulating tumor DNA and liquid biopsy in Nat Cancer 1, 276-290 (2020) doi: 10.1038/s43018-020-0043-5
.