Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Brazil.
Programa de Residência Multiprofissional em Saúde, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, Brazil.
Mol Cancer Res. 2020 Apr;18(4):517-528. doi: 10.1158/1541-7786.MCR-19-0768. Epub 2020 Jan 29.
Circulating tumor DNA (ctDNA) has recently emerged as a minimally invasive "liquid biopsy" tool in precision medicine. ctDNA-genomic DNA fragments that are released into the bloodstream after the active secretion of microvesicles or tumor cell lysis reflects tumor evolution and the genomic alterations present in primary and/or metastatic tumors. Notably, ctDNA analysis might allow the stratification of patients, the monitoring of the therapeutic response, and the establishment of an opportunity for early intervention independent of detection by imaging modalities or clinical symptoms. As oncology moves towards precision medicine, the information in ctDNA provides a means for the individual management of the patient based on their tumor's genetic profile. This review presents current evidence on the potential role for ctDNA in helping to guide individualized clinical treatment decisions for patients with melanoma, castration-resistant prostate cancer, breast cancer, metastatic colorectal cancer, and non-small cell lung cancer.
循环肿瘤 DNA（ctDNA）最近作为一种微创的“液体活检”工具在精准医学中崭露头角。ctDNA 是指基因组 DNA 片段，在微泡或肿瘤细胞裂解后主动分泌到血液中，反映了肿瘤的演变以及原发性和/或转移性肿瘤中存在的基因组改变。值得注意的是，ctDNA 分析可能允许对患者进行分层，监测治疗反应，并在不依赖影像学或临床症状检测的情况下为早期干预提供机会。随着肿瘤学向精准医学发展，ctDNA 中的信息为根据患者肿瘤的遗传特征对其进行个体化管理提供了一种手段。本综述介绍了 ctDNA 在帮助指导黑色素瘤、去势抵抗性前列腺癌、乳腺癌、转移性结直肠癌和非小细胞肺癌患者个体化临床治疗决策方面的潜在作用的现有证据。
