Department of Medicine, Royal Marsden Hospital, London and Surrey, United Kingdom.
Department of Medicine, Royal Marsden Hospital, London and Surrey, United Kingdom; Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom.
Crit Rev Oncol Hematol. 2018 Feb;122:72-82. doi: 10.1016/j.critrevonc.2017.12.002. Epub 2017 Dec 16.
Circulating cell free tumour DNA (ctDNA) maintains the same genomic alterations that are present in the corresponding tumour, thereby allowing for quantitative and qualitative real-time evaluation in body fluids as an alternative to onerous repeat biopsies. Improvements in the sensitivity of techniques used to identify ctDNA has led to a surge of research investigating its role in the detection of: early disease, relapse, response to therapy and emerging drug resistance mechanisms. Following curative surgery, ctDNA detection is a promising marker of minimal residual disease and could better select patients for adjuvant chemotherapy. Longitudinal monitoring could help identify early relapse. In metastatic disease, ctDNA can predict response to chemotherapy prior to evidence of disease progression on imaging and investigate novel primary and acquired resistance mechanisms to targeted therapies. More experience in detecting, analysing and interpreting ctDNA within prospective trials, will better define its role for implementation into routine clinical practice.
循环肿瘤游离 DNA（ctDNA）保留了与相应肿瘤相同的基因组改变，从而可以在体液中进行定量和定性的实时评估，作为繁琐的重复活检的替代方法。用于识别 ctDNA 的技术灵敏度的提高，促使人们对其在以下方面的作用进行了大量研究：早期疾病、复发、对治疗的反应以及新兴的耐药机制。在根治性手术后，ctDNA 检测是微小残留疾病的有前途的标志物，并可更好地选择辅助化疗的患者。纵向监测有助于识别早期复发。在转移性疾病中，ctDNA 可以在影像学上出现疾病进展之前预测对化疗的反应，并研究针对靶向治疗的新原发性和获得性耐药机制。在前瞻性试验中检测、分析和解释 ctDNA 方面的更多经验将更好地确定其在常规临床实践中的作用。
