Ionescu Filip, Zhang Jingsong, Wang Liang
Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA.
Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
Cancers (Basel). 2022 Mar 29;14(7):1728. doi: 10.3390/cancers14071728.
Prostate cancer (PC) remains the most common malignancy and the second most common cause of cancer death in men. As a result of highly variable biological behavior and development of resistance to available agents under therapeutic pressure, optimal management is often unclear. Traditional surgical biopsies, even when augmented by genomic studies, may fail to provide adequate guidance for clinical decisions as these can only provide a snapshot of a dynamic process. Additionally, surgical biopsies are cumbersome to perform repeatedly and often involve risk. Liquid biopsies (LB) are defined as the analysis of either corpuscular (circulating tumor cells, extracellular vesicles) or molecular (circulating DNA or RNA) tumor-derived material. LB could more precisely identify clinically relevant alterations that characterize the metastatic potential of tumors, predict response to specific treatments or actively monitor for the emergence of resistance. These tests can potentially be repeated as often as deemed necessary and can detect real-time response to treatment with minimal inconvenience to the patient. In the current review, we consider common clinical scenarios to describe available LB assays in PC as a platform to explore existing evidence for their use in guiding decision making and to discuss current limitations to their adoption in the clinic.
前列腺癌（PC）仍然是男性中最常见的恶性肿瘤，也是癌症死亡的第二大常见原因。由于其生物学行为高度可变，且在治疗压力下会对现有药物产生耐药性，因此最佳治疗方案往往并不明确。传统的手术活检，即使辅以基因组研究，也可能无法为临床决策提供充分指导，因为这些活检只能提供动态过程的一个快照。此外，手术活检反复进行很麻烦，而且往往存在风险。液体活检（LB）被定义为对细胞性（循环肿瘤细胞、细胞外囊泡）或分子性（循环DNA或RNA）肿瘤衍生物质的分析。液体活检能够更精确地识别表征肿瘤转移潜能的临床相关改变，预测对特定治疗的反应或积极监测耐药性的出现。这些检测可能根据需要尽可能频繁地重复进行，并且能够以对患者造成最小不便的方式检测对治疗的实时反应。在本综述中，我们考虑常见的临床情况，将前列腺癌中可用的液体活检检测方法作为一个平台来探讨其用于指导决策的现有证据，并讨论目前在临床应用中存在的局限性。
