Detection of incipient tumours by screening of circulating plasma DNA: hype or hope?

Acta Clin Belg. 2020 Feb;75(1):9-18. doi: 10.1080/17843286.2019.1671653. Epub 2019 Oct 3.

Abstract

Background: The last half-decade has been marked by a rapid expansion of research efforts in the field of so-called liquid biopsies, thereby investigating the potential of blood-derived cell-free tumour DNA (ctDNA) markers for application in clinical oncological management. The analysis of cfDNA appears to be particularly attractive for therapy monitoring purposes, while in terms of early cancer diagnosis and screening the potentials are just starting to be explored. Challenges, both of biological and technical nature, need to be addressed. One such challenge is to overcome the low levels of ctDNA in the circulation, intrinsic to many early-stage cancers. Methods: Here, we give an overview of the features of ctDNA and the approaches that are currently being applied with the ultimate aim to detect tumours in a presymptomatic stage. Conclusion: Although many studies report encouraging results, further technical development and larger studies are warranted before application of ctDNA analysis may find its place in clinic.

Keywords: Liquid biopsy; biomarker; cancer detection; cell-free DNA.

MeSH terms

  • Biomarkers, Tumor / blood
  • Biomarkers, Tumor / genetics
  • Circulating Tumor DNA / blood*
  • Circulating Tumor DNA / genetics
  • DNA Copy Number Variations
  • Early Detection of Cancer / methods*
  • Epigenesis, Genetic
  • Humans
  • Liquid Biopsy / methods
  • Mutation
  • Neoplasms / blood*
  • Neoplasms / diagnosis*
  • Neoplasms / genetics

Substances

  • Biomarkers, Tumor
  • Circulating Tumor DNA