Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia.
Department of Medical Oncology, Monash Health, Melbourne, Australia.
Cell Oncol (Dordr). 2019 Feb;42(1):13-28. doi: 10.1007/s13402-018-0413-5. Epub 2018 Oct 26.
The field of liquid biopsies in oncology is rapidly expanding, with the application of cell-free circulating tumour DNA (ctDNA) showing promise in this era of precision medicine. Compared with traditional clinical and radiographic tumour monitoring methods, the analysis of ctDNA provides a minimally-invasive and technically feasible approach to assess temporal and spatial molecular evolutions of the tumour landscape. The constantly advancing technological platforms available for ctDNA extraction and analysis allow greater analytical sensitivities than ever before. The potential translational impact of ctDNA as a blood-based biomarker for the identification, characterization and monitoring of cancer has been demonstrated in numerous proof-of-concept studies, with ctDNA analysis beginning to be applied clinically across multiple facets of oncology.
In this review we discuss the biology, recent advancements, technical considerations and clinical implications of ctDNA in the context of cancer, and highlight important challenges and future directions for the integration of ctDNA into standardised patient care.
肿瘤领域的液体活检正在迅速发展，游离循环肿瘤 DNA（ctDNA）的应用在精准医学时代显示出了前景。与传统的临床和影像学肿瘤监测方法相比，ctDNA 分析提供了一种微创且技术上可行的方法来评估肿瘤景观的时空分子演变。目前可用于 ctDNA 提取和分析的不断进步的技术平台提供了比以往任何时候都更高的分析灵敏度。ctDNA 作为一种基于血液的生物标志物，用于识别、表征和监测癌症的潜在转化影响已在众多概念验证研究中得到证实，ctDNA 分析开始在肿瘤学的多个方面得到临床应用。
在这篇综述中，我们讨论了 ctDNA 在癌症背景下的生物学、最新进展、技术考虑因素和临床意义，并强调了将 ctDNA 纳入标准化患者护理的重要挑战和未来方向。
