Authors: Giorgio Patelli, Caterina Vaghi, Federica Tosi, Gianluca Mauri, Alessio Amatu, Daniela Massihnia, Silvia Ghezzi, Erica Bonazzina, Katia Bencardino, Giulio Cerea, Salvatore Siena & Andrea Sartore-Bianchi
Abstract
Liquid biopsy recently gained widespread attention as a noninvasive alternative/complementary technique to tissue biopsy in patients with cancer. As technological advances have improved both feasibility and turnaround time, liquid biopsy has expanded tumor molecular analysis with acknowledgement of both spatial and temporal heterogeneity, overcoming many limitations of traditional tissue biopsy. Because of its diagnostic, prognostic, and predictive value, liquid biopsy has been extensively studied also in metastatic colorectal cancer. Indeed, as personalized medicine establishes its role in cancer treatment, genetic biomarkers unveiling the emergence of early resistance are needed. Among the wide variety of tumor analytes amenable to collection, circulating DNA and circulating tumor cells are the most adopted approaches, and both carry clinical relevance in colorectal cancer. However, few studies focused on comparing feasibility between these two approaches. In this review, we discuss the potential implications of liquid biopsy in metastatic colorectal cancer, assessing the advantages and drawbacks of circulating DNA and circulating tumor cells, and highlighting the most relevant trials for clinical practice.
Key Points |
Circulating tumor cells and circulating tumor DNA have been extensively studied in metastatic colorectal cancer with regard to their diagnostic, prognostic, and predictive impact; however, data of direct comparison between these two techniques are lacking. |
Circulating tumor DNA yields higher sensitivity and suitability than circulating tumor cells, thus being the main plasma biomarker employed in clinical trials and closer to reach clinical practice for metastatic colorectal cancer. However, circulating tumor cells boast the unique potential to serve as a platform for ex vivo culture and xenografting. |
Randomized clinical trials are needed to establish how to integrate liquid biopsy to improve the prognosis of patients affected by metastatic colorectal cancer. |