Vall d'Hebron Institute of Oncology (VHIO) and Vall d'Hebron University Hospital, Barcelona, Spain.
Departments of Human Genetics and Urology, Institute for Precision Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA.
Eur Urol. 2021 Jun;79(6):762-771. doi: 10.1016/j.eururo.2020.12.037. Epub 2021 Jan 7.
Genomic stratification can impact prostate cancer (PC) care through diagnostic, prognostic, and predictive biomarkers that aid in clinical decision-making. The temporal and spatial genomic heterogeneity of PC together with the challenges of acquiring metastatic tissue biopsies hinder implementation of tissue-based molecular profiling in routine clinical practice. Blood-based liquid biopsies are an attractive, minimally invasive alternative.
To review the clinical value of blood-based liquid biopsy assays in PC and identify potential applications to accelerate the development of precision medicine.
A systematic review of PubMed/MEDLINE was performed to identify relevant literature on blood-based circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), and extracellular vesicles (EVs) in PC.
Liquid biopsy has emerged as a practical tool to profile tumor dynamics over time, elucidating features that evolve (genome, epigenome, transcriptome, and proteome) with tumor progression. Liquid biopsy tests encompass analysis of DNA, RNA, and proteins that can be detected in CTCs, ctDNA, or EVs. Blood-based liquid biopsies have demonstrated promise in the context of localized tumors (diagnostic signatures, risk stratification, and disease monitoring) and advanced disease (response/resistance biomarkers and prognostic markers).
Liquid biopsies have value as a source of prognostic, predictive, and response biomarkers in PC. Most clinical applications have been developed in the advanced metastatic setting, where CTC and ctDNA yields are significantly higher. However, standardization of assays and analytical/clinical validation is necessary prior to clinical implementation.
Traces of tumors can be isolated from blood samples from patients with prostate cancer either as whole cells or as DNA fragments. These traces provide information on tumor features. These minimally invasive tests can guide diagnosis and treatment selection.
基因组分层可以通过诊断、预后和预测生物标志物影响前列腺癌（PC）的治疗，这些标志物有助于临床决策。PC 的时空基因组异质性以及获取转移性组织活检的挑战阻碍了组织分子谱分析在常规临床实践中的应用。基于血液的液体活检是一种有吸引力的、微创的替代方法。
综述基于血液的液体活检检测在 PC 中的临床价值，并确定潜在的应用，以加速精准医学的发展。
对 PubMed/MEDLINE 进行了系统的文献回顾，以确定与 PC 中基于血液的循环肿瘤细胞（CTC）、循环肿瘤 DNA（ctDNA）和细胞外囊泡（EVs）相关的文献。
液体活检已成为一种实用的工具，可以随时间描绘肿瘤动态，阐明随肿瘤进展而演变的特征（基因组、表观基因组、转录组和蛋白质组）。液体活检检测包括对 CTCs、ctDNA 或 EVs 中可检测的 DNA、RNA 和蛋白质进行分析。基于血液的液体活检在局部肿瘤（诊断特征、风险分层和疾病监测）和晚期疾病（反应/耐药生物标志物和预后标志物）中显示出一定的应用价值。
液体活检作为 PC 中预后、预测和反应生物标志物的来源具有价值。大多数临床应用都是在晚期转移性疾病中开发的，CTC 和 ctDNA 的产量明显更高。然而，在临床实施之前，需要对检测方法进行标准化和分析/临床验证。
可以从患有前列腺癌的患者的血液样本中分离出肿瘤的痕迹，这些痕迹可以作为完整细胞或 DNA 片段提供肿瘤特征的信息。这些微创测试可以指导诊断和治疗选择。
