Lustberg Maryam B, Stover Daniel G, Chalmers Jeffrey J
Cancer J. 2018 Mar/Apr;24(2):61-64. doi: 10.1097/PPO.0000000000000309.
A primary goal of personalized medicine is to develop tumor-specific biomarkers to aid in treatment selection and to better evaluate response to targeted therapies. The assessment of circulating blood markers as surrogate real-time biopsies of disease status, termed liquid biopsies, has been under investigation. There are many different types of liquid biopsies each with different functionalities and limitations. These include tumor markers, circulating tumor cells, cell-free DNA, and extracellular vesicles including exosomes. Multiple clinical trials have evaluated liquid biopsies as prognostic biomarkers with positive results. Additional studies are underway to evaluate liquid biopsies as predictive biomarkers, pharmacodynamic biomarkers, and surrogate efficacy endpoints for treatment response evaluation. There are several challenges in and barriers to implementation of liquid biopsies into clinical trials and subsequently into routine clinical practice, which are addressed in this review.
精准医学的一个主要目标是开发肿瘤特异性生物标志物，以辅助治疗选择并更好地评估对靶向治疗的反应。将循环血液标志物评估作为疾病状态的替代实时活检，即所谓的液体活检，一直在研究中。有许多不同类型的液体活检，每种都有不同的功能和局限性。这些包括肿瘤标志物、循环肿瘤细胞、游离DNA以及包括外泌体在内的细胞外囊泡。多项临床试验已将液体活检评估为预后生物标志物，结果呈阳性。正在进行更多研究，以评估液体活检作为预测性生物标志物、药效学生物标志物以及用于治疗反应评估的替代疗效终点。将液体活检应用于临床试验并随后应用于常规临床实践存在若干挑战和障碍，本综述将对此进行探讨。
