IJzerman Maarten J, Berghuis A M Sofie, de Bono Johann S, Terstappen Leon W M M
a Department of Health Technology and Services Research , University of Twente , Enschede , the Netherlands.
b University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences , Victorian Comprehensive Cancer Centre and Centre for Cancer Research , Melbourne , Australia.
Expert Rev Pharmacoecon Outcomes Res. 2018 Dec;18(6):593-599. doi: 10.1080/14737167.2018.1505505. Epub 2018 Aug 7.
Liquid biopsies (LBs) are referred to as the sampling and analysis of non-solid tissue, primarily blood, as a diagnostic and monitoring tool for cancer. Because LBs are largely non-invasive, they are a less-costly alternative for serial analysis of tumor progression and heterogeneity to facilitate clinical management. Although a variety of tumor markers are proposed (e.g., free-circulating DNA), the clinical evidence for Circulating Tumor Cells (CTCs) is currently the most developed. Areas covered: This paper presents a health economic perspective of LBs in cancer management. We first briefly introduce the requirements in biomarker development and validation, illustrated for CTCs. Second, we discuss the state-of-art on the clinical utility of LBs in breast cancer in more detail. We conclude with a future perspective on the clinical use and reimbursement of LBs Expert commentary: A significant increase in clinical research on LBs can be observed and the results suggest a rapid change of cancer management. In addition to studies evaluating clinical utility of LBs, a smooth translation into clinical practice requires systematic assessment of the health economic benefits. This paper argues that (early stage) health economic research is required to facilitate its clinical use and to prioritize further evidence development.
液体活检（LBs）是指对非实体组织（主要是血液）进行采样和分析，作为癌症的诊断和监测工具。由于液体活检在很大程度上是非侵入性的，因此对于连续分析肿瘤进展和异质性以促进临床管理而言，它是一种成本较低的替代方法。尽管人们提出了多种肿瘤标志物（例如游离循环DNA），但目前循环肿瘤细胞（CTC）的临床证据最为充分。涵盖领域：本文从卫生经济学角度阐述了液体活检在癌症管理中的应用。我们首先简要介绍生物标志物开发和验证的要求，并以循环肿瘤细胞为例进行说明。其次，我们更详细地讨论液体活检在乳腺癌临床应用方面的最新进展。最后，我们对液体活检的临床应用和报销前景进行了展望。专家评论：可以观察到液体活检的临床研究显著增加，结果表明癌症管理正在迅速变革。除了评估液体活检临床应用的研究外，要顺利转化为临床实践还需要对卫生经济效益进行系统评估。本文认为，需要开展（早期）卫生经济研究以促进其临床应用，并确定进一步证据开发的优先顺序。
