Theil G, Fornara P
Universitätsklinik und Poliklinik für Urologie, Nierentransplantationszentrum, Universitätsklinikum Halle (Saale), Ernst-Grube Str. 40, 06120, Halle/Saale, Deutschland.
Urologe A. 2018 Sep;57(9):1069-1074. doi: 10.1007/s00120-018-0692-5.
The molecular characterization of biomarkers will be fundamental for personalized medicine. New therapeutic targets have been identified in urological tumors (mainly in prostate cancer) and are currently being investigated in clinical trials. Tissue biopsies are associated with high costs, morbidity of the biopsy sample, and only allow analysis of a point-shaped part of the tumor. The liquid biopsy of circulating tumor cells (CTCs) and cell-free DNA (cfDNA) are noninvasive ways to detect specific changes in the tumor. There are still a few challenges to overcome, e. g., the stability and origin of the CTCs and cfDNA. The detection methods are not yet standardized which makes quality management more difficult. The main applications of liquid biopsy have led to a boom in the field of molecular diagnostics, which does not always have to do with the extended understanding of the individual analytes, but much more on the better sensitivity of the technologies. Despite the tremendous progress made in recent years in the field of liquid biopsy, this has not led to clinical implementation. There is still a lack of validated treatment guidelines in which the results of liquid biopsies can be integrated.
生物标志物的分子特征对于个性化医疗至关重要。在泌尿系统肿瘤（主要是前列腺癌）中已确定了新的治疗靶点，目前正在临床试验中进行研究。组织活检成本高，活检样本有并发症，且仅能分析肿瘤的点状部分。循环肿瘤细胞（CTC）和游离DNA（cfDNA）的液体活检是检测肿瘤特异性变化的非侵入性方法。仍有一些挑战需要克服，例如CTC和cfDNA的稳定性及来源。检测方法尚未标准化，这使得质量管理更加困难。液体活检的主要应用推动了分子诊断领域的蓬勃发展，这并不总是与对单个分析物的深入理解有关，而更多地在于技术具有更高的灵敏度。尽管近年来液体活检领域取得了巨大进展，但这尚未导致临床应用。仍然缺乏可纳入液体活检结果的经过验证的治疗指南。
